Maillard Nicolas, Delanaye Pierre, Mariat Christophe
Service de néphrologie, Laboratoire d'explorations fonctionnelles rénales, Centre hospitalier universitaire de Saint-Étienne, Université Jean Monnet, 42055 Saint-Étienne cedex 02, France.
Service de néphrologie, dialyse et transplantation, Centre hospitalier universitaire Sart Tilman, Université de Liège, Liège, Belgique.
Nephrol Ther. 2015 Feb;11(1):54-67. doi: 10.1016/j.nephro.2015.01.002. Epub 2015 Feb 14.
In addition to direct measurement methods of glomerular filtration rate, there are many formulas whose purpose is to estimate glomerular filtration rate from endogenous markers, of which the most used is serum creatinine. The latest recommendations the French health agency Haute Autorité de santé (HAS) unambiguously endorse the use of the CKD-EPI equation. The assessment of glomerular filtration rate from this equation however remains approximate in many situations where the plasma creatinine concentration poorly reflects the glomerular filtration rate. In these situations, plasma cystatin C could potentially be a more reliable alternative to endogenous plasma creatinine marker, especially since a reference standard for the determination of serum cystatin C concentration has recently been developed. Use of serum cystatin C concentration in clinical practice begins to be mentioned, but still needs to be fully validated.
除了肾小球滤过率的直接测量方法外，还有许多公式旨在通过内源性标志物来估算肾小球滤过率，其中使用最广泛的是血清肌酐。法国卫生机构高级卫生管理局（HAS）的最新建议明确支持使用CKD-EPI方程。然而，在许多血浆肌酐浓度不能很好反映肾小球滤过率的情况下，根据该方程评估肾小球滤过率仍然是近似的。在这些情况下，血浆胱抑素C可能是内源性血浆肌酐标志物更可靠的替代物，特别是因为最近已经开发出了测定血清胱抑素C浓度的参考标准。临床实践中开始提及使用血清胱抑素C浓度，但仍需要充分验证。
