Tsujimura Kazuma, Ota Morihito, Chinen Kiyoshi, Adachi Takayuki, Nagayama Kiyomitsu, Oroku Masato, Nishihira Morikuni, Shiohira Yoshiki, Iseki Kunitoshi, Ishida Hideki, Tanabe Kazunari
Department of Surgery, Tomishiro Central Hospital, Tomigusuku, Okinawa, Japan.
Department of Nephrology, Tomishiro Central Hospital, Tomigusuku, Okinawa, Japan.
Ann Transplant. 2017 Jun 23;22:378-383. doi: 10.12659/aot.903355.
BACKGROUND Precise evaluation of a living donor's renal function is necessary to ensure adequate residual kidney function after donor nephrectomy. Our aim was to evaluate the feasibility of estimating glomerular filtration rate (GFR) using serum cystatin-C prior to kidney transplantation. MATERIAL AND METHODS Using the equations of the Japanese Society of Nephrology, we calculated the GFR using serum creatinine (eGFRcre) and cystatin C levels (eGFRcys) for 83 living kidney donors evaluated between March 2010 and March 2016. We compared eGFRcys and eGFRcre values against the creatinine clearance rate (CCr). RESULTS The study population included 27 males and 56 females. The mean eGFRcys, eGFRcre, and CCr were, 91.4±16.3 mL/min/1.73 m² (range, 59.9-128.9 mL/min/1.73 m²), 81.5±14.2 mL/min/1.73 m² (range, 55.4-117.5 mL/min/1.73 m²) and 108.4±21.6 mL/min/1.73 m² (range, 63.7-168.7 mL/min/1.73 m²), respectively. eGFRcys was significantly lower than CCr (p<0.001). The correlation coefficient between eGFRcys and CCr values was 0.466, and the mean difference between the two values was -17.0 (15.7%), with a root mean square error of 19.2. Thus, eGFRcre was significantly lower than CCr (p<0.001). The correlation coefficient between eGFRcre and CCr values was 0.445, and the mean difference between the two values was -26.9 (24.8%), with a root mean square error of 19.5. CONCLUSIONS Although eGFRcys provided a better estimation of GFR than eGFRcre, eGFRcys still did not provide an accurate measure of kidney function in Japanese living kidney donors.
精确评估活体供体的肾功能对于确保供肾切除术后有足够的残余肾功能至关重要。我们的目的是评估在肾移植前使用血清胱抑素C估算肾小球滤过率（GFR）的可行性。材料与方法：采用日本肾脏病学会的公式，我们计算了2010年3月至2016年3月期间接受评估的83名活体肾供体的血清肌酐（eGFRcre）和胱抑素C水平（eGFRcys）对应的GFR。我们将eGFRcys和eGFRcre值与肌酐清除率（CCr）进行了比较。结果：研究人群包括27名男性和56名女性。eGFRcys、eGFRcre和CCr的平均值分别为91.4±16.3 mL/min/1.73 m²（范围为59.9 - 128.9 mL/min/1.73 m²）、81.5±14.2 mL/min/1.73 m²（范围为55.4 - 117.5 mL/min/1.73 m²）和108.4±21.6 mL/min/1.73 m²（范围为63.7 - 168.7 mL/min/1.73 m²）。eGFRcys显著低于CCr（p<0.001）。eGFRcys与CCr值之间的相关系数为0.466，两者之间的平均差值为 -17.0（15.7%），均方根误差为19.2。因此，eGFRcre显著低于CCr（p<0.001）。eGFRcre与CCr值之间的相关系数为0.445，两者之间的平均差值为 -26.9（24.8%），均方根误差为19.5。结论：尽管eGFRcys比eGFRcre能更好地估算GFR，但在日本活体肾供体中，eGFRcys仍不能准确测量肾功能。
