Matsuki Masahiro, Tanaka Toshiaki, Maehana Takeshi, Ichihara Koji, Yanase Masahiro, Matsukawa Masanori, Adachi Hideki, Takahashi Satoshi, Masumori Naoya
Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan.
Sapporo Kidney Disease Treatment Forum, Sapporo, Japan.
Asian J Urol. 2015 Jul;2(3):167-169. doi: 10.1016/j.ajur.2015.07.003. Epub 2015 Jul 15.
Recently, serum cystatin C (CysC) has been used as a novel marker of renal function. However, there is a lack of data on CysC levels in patients with intestinal urinary diversion (UD). Here we report CysC levels in such patients.
We prospectively observed 38 patients who were diagnosed with bladder cancer and subsequently treated with radical cystectomy and UD at our institution in 2012 and 2013. Serum creatinine (sCr) and CysC were obtained optionally at the same time at least 1 month after radical cystectomy and UD.
The median CysC and sCr concentrations were 1.12 mg/L (range 0.75-2.47 mg/L) and 0.99 mg/dL (range 0.61-2.22 mg/dL), respectively. The median estimated concentrations of glomerular filtration rate (GFR) based on CysC (eGFRcys) and GFR based on creatinine (eGFRcreat) were 61.08 mL/min/1.73 m (range 22.64-99.89 mL/min/1.73 m) and 58.01 mL/min/1.73 m (range 23.48-91.82 mL/min/1.73 m), respectively. CysC had a significant correlation with sCr ( = 0.8607, < 0.0001) and eGFRcreat ( = -0.8993, < 0.0001). eGFRcys also had a significant correlation with eGFRcreat ( = 0.8104, < 0.0001).
The correlation between CysC and sCr was strong and the correlation coefficient was equivalent to that in patients without UD. The results suggest that CysC is not affected by UD and can be used as a marker of renal function similarly to sCr in patients with UD.
近年来，血清胱抑素C（CysC）已被用作肾功能的一种新型标志物。然而，关于肠道尿流改道术（UD）患者的CysC水平的数据尚缺乏。在此我们报告此类患者的CysC水平。
我们前瞻性观察了38例于2012年和2013年在我院被诊断为膀胱癌并随后接受根治性膀胱切除术和UD治疗的患者。在根治性膀胱切除术和UD后至少1个月的同一时间随意获取血清肌酐（sCr）和CysC。
CysC和sCr的中位数浓度分别为1.12mg/L（范围0.75 - 2.47mg/L）和0.99mg/dL（范围0.61 - 2.22mg/dL）。基于CysC的肾小球滤过率（GFR）估计浓度（eGFRcys）和基于肌酐的GFR（eGFRcreat）的中位数分别为61.08mL/min/1.73m²（范围22.64 - 99.89mL/min/1.73m²）和58.01mL/min/1.73m²（范围23.48 - 91.82mL/min/1.73m²）。CysC与sCr显著相关（r = 0.8607，P < 0.0001），与eGFRcreat也显著相关（r = -0.8993，P < 0.0001）。eGFRcys与eGFRcreat也显著相关（r = 0.8104，P < 0.0001）。
CysC与sCr之间的相关性很强，且相关系数与无UD患者的相当。结果表明CysC不受UD影响，在UD患者中可与sCr一样用作肾功能标志物。
