Takahashi Makoto, Takayama Sintarou, Suga Hideyuki, Kadomura Shota, Kojima Masakazu, Iwao Kazunari, Takeda Kiyotaka, Sato Hideki, Kobayashi Michiya, Saitoh Hiroshi
Renal and Drug Study Group in Hokkaido; Sapporo Minami Ichijo Hospital.
Department of Pharmacy, Hokkaido Gastroenterology Hospital.
Yakugaku Zasshi. 2020;140(1):81-90. doi: 10.1248/yakushi.18-00225.
We previously reported the association of the estimated glomerular filtration rate (eGFR) calculated from the serum creatinine level (S-Cr) measured using the Jaffe method with the GFR (eGFR) estimated from the serum cystatin C level (CysC). However, few studies have compared the eGFR using the enzymatic method with the eGFR. It is unclear whether there are differences in the results of renal function assessment. The purpose of this study was to compare the eGFR calculated from the S-Cr with the eGFR calculated from the CysC in patients in whom the S-Cr and CysC were simultaneously measured using the enzymatic method, examine the correlations of respective parameters, and clarify physiological factors involved in differences among the parameters. The subjects were 1334 patients treated in 5 institutions. The mean values and correlation coefficient were statistically analyzed using Student's t-test and Pearson's test, respectively. Influential factors between formulae were analyzed using multiple regression analysis. The mean eGFR was 67.0 mL/min/1.73 m, being significantly higher than the mean eGFR (63.2). Multiple regression analysis showed that factors influencing differences in the S-Cr and CysC included the sex, age, serum albumin, and blood urea nitrogen BUN/S-Cr. Furthermore, factors involved in the overestimation of the eGFR in comparison with the eGFR included the serum albumin and BUN/S-Cr. The differences between the eGFR calculated from the S-Cr and eGFR were less marked than when adopting the Jaffe method in our previous study. However, the eGFR were higher than the eGFR in patients with malnutrition or dehydration.
我们之前报道了通过使用Jaffe法测量的血清肌酐水平(S-Cr)计算出的估算肾小球滤过率(eGFR)与通过血清胱抑素C水平(CysC)估算的肾小球滤过率(eGFR)之间的关联。然而,很少有研究将酶法测定的eGFR与该eGFR进行比较。尚不清楚肾功能评估结果是否存在差异。本研究的目的是比较在使用酶法同时测量S-Cr和CysC的患者中,由S-Cr计算出的eGFR与由CysC计算出的eGFR,检查各参数之间的相关性,并阐明参数差异所涉及的生理因素。研究对象为在5家机构接受治疗的1334例患者。分别使用Student's t检验和Pearson检验对平均值和相关系数进行统计学分析。使用多元回归分析来分析公式之间的影响因素。平均eGFR为67.0 mL/min/1.73 m²,显著高于平均eGFR(63.2)。多元回归分析表明,影响S-Cr和CysC差异的因素包括性别、年龄、血清白蛋白以及血尿素氮BUN/S-Cr。此外,与eGFR相比,导致eGFR高估的因素包括血清白蛋白和BUN/S-Cr。与我们之前研究中采用Jaffe法时相比,由S-Cr计算出的eGFR与eGFR之间的差异不那么明显。然而,在营养不良或脱水患者中,该eGFR高于eGFR。