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[使用胱抑素C方程评估肾脏供体候选健康成年人群肾小球滤过率的研究。]

[Evaluation of equations using cystatin C for estimation of the glomerular filtration rate in healthy adult population of canidates for kidney donors.].

作者信息

Medina Arnaudo Gisel Ivana

机构信息

Hospital Privado Centro Médico de Córdoba.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2017 Sep 8;74(3):243-250. doi: 10.31053/1853.0605.v74.n3.14814.

Abstract

The determination of the glomerular filtration rate (GFR) is critical for the selection of potential kidney donors. Methods of measurement of GFR are impractical and complex, which led to development of equations to estimate GFR. Objective: To evaluate of the performance of Creatinine and Cystatin C based equation for estimation of GFR in healthy adult population of candidates for kidney donors. Materials and Methods: a cross-sectional study was performed in 72 adult patients evaluated as candidates for kidney donors. GFR was measured by nonradiolabeled Iothalamate clearence (mGFR). GFR was estimated by the Modification of Diet in Renal Disease (eGFR MDRD) equation, Chronic Kidney Disease Epidemiology Collaboration study (eGFR CKD-EPICREAT, eGFR CKD-EPI-CREAT+CYSC) and the equation proposed by Stevens et al. (STEVENSCREAT+CYSC). The overall performance of all equations was analyzed. Results: eGFR CKD-EPICREAT+CYSC, eGFR STEVENS CREAT+CYSC and eGFR CKD-EPI-CREAT presented lower bias (1,93; - 0,71; -1,53 mL/ min/1,73m2 respectively) compared with eGFR MDRD (bias= -10,36 mL/min/1.73m2). This study demonstrated that the best diagnostic performance was shown by eGFR CKD-EPICREAT+CYSC (LR(+)=9,8; “Positive Likelihood Ratios”), followed by eGFR STEVENSCREAT+CYSC (LR(+)=4,7) and eGFR CKD-EPICREAT (LR(+)=3,7). Discussion: CKD-EPICREAT+CYSC, STEVENS-CREAT+CYSC and CKDEPI-CREAT equations demonstrated a clearly higher performance to estimate GFR compared with MDRD in the study population.

摘要

肾小球滤过率(GFR)的测定对于潜在肾脏供体的选择至关重要。GFR的测量方法不切实际且复杂,这促使了估算GFR方程的发展。目的:评估基于肌酐和胱抑素C的方程在健康成年肾脏供体候选人群中估算GFR的性能。材料与方法:对72名被评估为肾脏供体候选者的成年患者进行了一项横断面研究。通过非放射性碘海醇清除率(mGFR)测量GFR。通过肾脏病饮食改良(eGFR MDRD)方程、慢性肾脏病流行病学协作研究(eGFR CKD - EPICREAT、eGFR CKD - EPI - CREAT + CYSC)以及Stevens等人提出的方程(STEVENSCREAT + CYSC)估算GFR。分析了所有方程的总体性能。结果:与eGFR MDRD(偏差 = -10.36 mL/min/1.73m²)相比,eGFR CKD - EPICREAT + CYSC、eGFR STEVENS CREAT + CYSC和eGFR CKD - EPI - CREAT的偏差较低(分别为1.93; -0.71; -1.53 mL/min/1.73m²)。本研究表明,eGFR CKD - EPICREAT + CYSC表现出最佳诊断性能(LR(+) = 9.8;“阳性似然比”),其次是eGFR STEVENSCREAT + CYSC(LR(+) = 4.7)和eGFR CKD - EPICREAT(LR(+) = 3.7)。讨论:在研究人群中,CKD - EPICREAT + CYSC、STEVENS - CREAT + CYSC和CKD - EPI - CREAT方程在估算GFR方面表现出明显高于MDRD的性能。

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