Zaffanello Marco, Franchini Massimo, Fanos Vassilios
Department of Mother-Child and Biology-Genetics, University of Verona, Piazzale L Scuro 10, Verona, Italy.
Ann Clin Lab Sci. 2007 Summer;37(3):233-40.
Cystatin C (Cys-C) is a low-molecular weight (13 kDa) protein that is a member of the cysteine protease family and is produced by all nucleated cells. In normal conditions, serum Cys-C is almost completely filtered by the renal glomerulus and largely catabolized by proximal tubular cells. Since serum Cys-C levels are closely correlated with the glomerular filtration rate (GFR), serum Cys-C assay has been introduced as a marker of renal function in patients with kidney diseases. In this review, we focus on studies reported during the past decade in which serum Cys-C levels have been compared to serum creatinine levels as a marker of GFR in pediatric populations. All but one of these studies showed diagnostic superiority or equivalence of serum Cys-C levels vs serum creatinine levels in children. The recent evidence from clinical trials generally supports the use of serum Cys-C assays as a renal function test in pediatric patients. However, clinicians should be cognizant of extrarenal conditions and pharmacological factors that can influence the results of serum Cys-C assays.
胱抑素C（Cys-C）是一种低分子量（13 kDa）蛋白质，属于半胱氨酸蛋白酶家族，由所有有核细胞产生。在正常情况下，血清Cys-C几乎完全由肾小球滤过，并在很大程度上由近端肾小管细胞分解代谢。由于血清Cys-C水平与肾小球滤过率（GFR）密切相关，血清Cys-C检测已被用作肾病患者肾功能的标志物。在本综述中，我们重点关注过去十年中报道的研究，这些研究将儿童人群中血清Cys-C水平与血清肌酐水平作为GFR的标志物进行了比较。除一项研究外，所有这些研究均显示儿童血清Cys-C水平相对于血清肌酐水平具有诊断优越性或等效性。来自临床试验的最新证据普遍支持将血清Cys-C检测用作儿科患者的肾功能测试。然而，临床医生应认识到可能影响血清Cys-C检测结果的肾外情况和药理因素。
