Yap Michael, Lamarche Jorge, Peguero Alfredo, Courville Craig
James A Haley Veterans' Affairs Hospital, Tampa, Florida 33612, USA.
J Ren Care. 2011 Sep;37(3):155-7. doi: 10.1111/j.1755-6686.2011.00228.x.
Cystatin C has emerged as a possible, usable surrogate marker of renal function. We present a case that illustrates the clinical utility of cystatin C in the setting of acute kidney injury secondary to rhabdomyolysis. An African American male whose baseline cystatin C and serum creatinine levels taken a month prior to admission were compared against their daily values during his admission and at follow up. On admission, the patient's reduction in glomerular filtration rate (GFR) from baseline was much less when calculated with cystatin C than with serum creatinine. His clinical recovery was more reflective of the higher GFR with cystatin C than what would be assumed with his serum creatinine, which at its worst was 5 ml/min/1.73 m(2). The patient was eventually discharged from the hospital with a GFR of 40 ml/min by cystatin C despite his GFR by the MDRD equation being 12. Cystatin C may be a more accurate marker of the both the amount of injury and the rate of resolution of acute kidney injury than serum creatinine in rhabdomyolysis.
胱抑素C已成为一种可能有用的肾功能替代标志物。我们报告一例病例，以说明胱抑素C在横纹肌溶解继发急性肾损伤情况下的临床应用。一名非裔美国男性，将其入院前一个月的基线胱抑素C和血清肌酐水平与其住院期间及随访时的每日值进行比较。入院时，用胱抑素C计算时，患者肾小球滤过率（GFR）较基线的降低幅度远小于用血清肌酐计算时。与血清肌酐相比，他的临床恢复情况更能反映胱抑素C所显示的较高GFR，血清肌酐最差时为5 ml/min/1.73 m²。尽管根据MDRD方程计算其GFR为12，但最终该患者出院时用胱抑素C测得的GFR为40 ml/min。在横纹肌溶解中，与血清肌酐相比，胱抑素C可能是急性肾损伤损伤程度和恢复速度更准确的标志物。
