Chiurchiu Carlos, Garces Nilda, Garay Gabriela, Holtz Rosmarie, Douthat Walter, de Arteaga Javier, Capra Raul, Massari Pablo U
Servicio de Nefrologia, Hospital Privado Centro Médico de Córdoba, Córdoba, Argentina.
Medicina (B Aires). 2007;67(2):136-42.
Serum creatinine is an insensitive marker to identify early changes in glomerular filtration rate (GFR), for this reason alternative methods to estimate renal function result of great clinical importance. Forty-one patients were studied using creatinine clearance modified with cimetidina (Clcrc) as surrogate of GFR, cystatin C-based equations (i.e. Larsson and Hoek formulas), Cockroft-Gault and MDRD abbreviated equations. In the whole group, as well as in those patients with serum creatinine < or =1.2 mg/dl--but reduced renal function: Clcrc 62.01 +/- 17.33 ml/ min/1.73 m(2)-, Larsson and Hoek equations showed higher correlations and lower bias than creatinine-based formulas. Abbreviated MDRD equation showed good performance just in those patients with evident alteration of renal function (serum creatinine > 1.2 mg/dl). We concluded that in patients with different stages of renal function, cystatin C-based equations detect reduction of renal function earlier than the serum creatinine-based formulas.
血清肌酐是一种用于识别肾小球滤过率(GFR)早期变化的不敏感标志物,因此,评估肾功能的替代方法具有重要的临床意义。我们使用西咪替丁修正的肌酐清除率(Clcrc)作为GFR的替代指标,基于胱抑素C的公式(即拉尔森公式和赫克公式)、简化的 Cockcroft-Gault 公式和简化的 MDRD 公式,对41例患者进行了研究。在整个研究组中,以及在那些血清肌酐≤1.2 mg/dl但肾功能降低的患者中(Clcrc为62.01±17.33 ml/min/1.73 m²),拉尔森公式和赫克公式比基于肌酐的公式显示出更高的相关性和更低的偏差。简化的MDRD公式仅在那些肾功能明显改变(血清肌酐>1.2 mg/dl)的患者中表现良好。我们得出结论,在不同肾功能阶段的患者中,基于胱抑素C的公式比基于血清肌酐的公式能更早地检测到肾功能的降低。