Tanaka Akihiro, Suemaru Katsuya, Araki Hiroaki
Division of Pharmacy, Ehime University Hospital, 454 Shitsukawa, Toon, Ehime 791-0295, Japan.
J Pharmacol Sci. 2007 Sep;105(1):1-5. doi: 10.1254/jphs.cp0070058. Epub 2007 Sep 8.
In clinical practice, the measurement of endogenous serum substances in order to estimate glomerular filtration rate (GFR) is commonly performed, and the serum creatinine level has become the most commonly used serum marker of renal function. However, the measurement of the serum creatinine concentration can sometimes lead to an overestimation of GFR, especially in the elderly. In recent years, it has been suggested that GFR can be predicted based on the serum cystatin C concentrations and that the serum cystatin C concentration is not influenced by gender or age. A recent meta-analysis demonstrated that serum cystatin C is a better marker for GFR than serum creatinine. In clinical practice, it has been suggested that serum cystatin C can optimize early detection for diabetic or hypertensive nephropathy. In addition, the use of serum cystatin C is possibly more appropriate for establishing an appropriate dose adjustment of drugs that are mainly eliminated by the kidney.
在临床实践中，为估算肾小球滤过率（GFR）而对内源性血清物质进行测量是常见操作，血清肌酐水平已成为最常用的肾功能血清标志物。然而，血清肌酐浓度的测量有时会导致对GFR的高估，尤其是在老年人中。近年来，有人提出可根据血清胱抑素C浓度预测GFR，且血清胱抑素C浓度不受性别或年龄影响。最近的一项荟萃分析表明，血清胱抑素C是比血清肌酐更好的GFR标志物。在临床实践中，有人提出血清胱抑素C可优化糖尿病或高血压肾病的早期检测。此外，使用血清胱抑素C可能更适合确定主要经肾脏排泄药物的合适剂量调整。
