通过胱抑素C快速评估年轻人的肾储备功能。
Rapid assessment of renal reserve in young adults by cystatin C.
作者信息
Fuhrman Dana Y, Maier Paula S, Schwartz George J
机构信息
a Pediatric Nephrology, University of Rochester Medical Center , Rochester, NY USA.
出版信息
Scand J Clin Lab Invest. 2013;73(4):265-8. doi: 10.3109/00365513.2013.765964. Epub 2013 Mar 5.
BACKGROUND
The kidney can increase glomerular filtration rate (GFR) in response to a protein load (renal reserve). In a pilot study of healthy young adults we examined renal reserve using changes in serum cystatin C (cysC).
METHODS
Glomerular filtration rate was obtained using iohexol single slope plasma disappearance. To stimulate GFR, subjects ingested a beefburger containing 60 grams of protein. CysC was measured by immunonephelometry before and 125-141 minutes after protein loading.
RESULTS
All subjects were found to have a normal iohexol plasma disappearance GFR with a mean of 104.6 ± 9.9 mL/min per 1.73 m(2). CysC decreased in each subject after the meat meal. Baseline cysC-based estimated GFR was 98.1 ± 9.1 mL/min per 1.73 m(2) with a mean increase of 12.0 ± 5.2 (p = 0.0003).
CONCLUSIONS
Our study showed a consistent decrease in serum cysC and increase in cysC-based estimated GFR following a protein load in young adults. Further studies are needed using renal clearance methods to confirm that cysC accurately determines renal reserve in patients with and without chronic kidney disease.
背景
肾脏可响应蛋白质负荷增加肾小球滤过率（GFR）（肾储备）。在一项针对健康年轻成年人的初步研究中，我们利用血清胱抑素C（cysC）的变化来检测肾储备。
方法
采用碘海醇单斜率血浆清除率测定肾小球滤过率。为刺激GFR，受试者摄入一个含有60克蛋白质的牛肉汉堡。在蛋白质负荷前及负荷后125 - 141分钟通过免疫比浊法测定cysC。
结果
所有受试者碘海醇血浆清除率GFR均正常，平均为每1.73 m² 104.6 ± 9.9 mL/min。进食肉类餐后，每个受试者的cysC均下降。基于基线cysC估算的GFR为每1.73 m² 98.1 ± 9.1 mL/min，平均增加12.0 ± 5.2（p = 0.0003）。
结论
我们的研究表明，年轻成年人在蛋白质负荷后，血清cysC持续下降，基于cysC估算的GFR增加。需要进一步采用肾脏清除方法进行研究，以证实cysC能否准确测定慢性肾脏病患者和非慢性肾脏病患者的肾储备。
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