Herget-Rosenthal Stefan, van Wijk Joanna A E, Bröcker-Preuss Martina, Bökenkamp Arend
Department of Nephrology, University Hospital, Essen, University Duisburg-Essen, Germany.
Clin Biochem. 2007 Sep;40(13-14):946-51. doi: 10.1016/j.clinbiochem.2007.04.013. Epub 2007 Apr 27.
The ratio of the urinary mass concentrations of cystatin C and creatinine (UcysC/Ucrea)>/=11.3 mg/mmol has recently been proposed as an accurate marker for the detection of GFR</=60 mL/min/1.73 m(2).
We prospectively evaluated the diagnostic performance of UcysC/Ucrea>/=11.3 mg/mmol and factors associated with increased UcysC/Ucrea in 72 children and adults with a wide variety of renal disorders. UcysC/Ucrea was calculated, and GFR wad estimated from serum creatinine and cystatin C by equations.
UcysC/Ucrea>/=11.3 mg/mmol had a low diagnostic value to detect GFR values</=60 mL/min/1.73 m(2) estimated by creatinine or cystatin-C-based equations with sensitivities of 72% and 63%, and specificities of 42% and 34%. ROC curves for UcysC/Ucrea to detect GFR</=60 mL/min/1.73 m(2) confirmed this with AUCs of 0.59 for creatinine and 0.57 for cystatin-C-based equations. Multivariate analysis identified tubular proteinuria, tubulointerstitial disease and heavy proteinuria, but not GFR</=60 mL/min/1.73 m(2), as factors independently associated with increased UcysC/Ucrea.
UcysC/Ucrea>/=11.3 mg/mmol is not an accurate marker to detect GFR</=60 mL/min/1.73 m(2), but reflects tubular dysfunction and proteinuria due to heavy proteinuria and tubulointerstitial disease.
最近有人提出，尿胱抑素C与肌酐的质量浓度比（UcysC/Ucrea）≥11.3 mg/mmol是检测肾小球滤过率（GFR）≤60 mL/min/1.73 m²的准确标志物。
我们前瞻性评估了UcysC/Ucrea≥11.3 mg/mmol的诊断性能以及72例患有各种肾脏疾病的儿童和成人中UcysC/Ucrea升高的相关因素。计算UcysC/Ucrea，并通过公式根据血清肌酐和胱抑素C估算GFR。
UcysC/Ucrea≥11.3 mg/mmol对检测基于肌酐或胱抑素C的公式估算的GFR值≤60 mL/min/1.73 m²的诊断价值较低，敏感性分别为72%和63%，特异性分别为42%和34%。UcysC/Ucrea检测GFR≤60 mL/min/1.73 m²的ROC曲线证实了这一点，基于肌酐的公式的曲线下面积（AUC）为0.59，基于胱抑素C的公式的AUC为0.57。多变量分析确定肾小管蛋白尿、肾小管间质疾病和大量蛋白尿是与UcysC/Ucrea升高独立相关的因素，而不是GFR≤60 mL/min/1.73 m²。
UcysC/Ucrea≥11.3 mg/mmol不是检测GFR≤60 mL/min/1.73 m²的准确标志物，但反映了由于大量蛋白尿和肾小管间质疾病导致 的肾小管功能障碍和蛋白尿。
