Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
Scand J Clin Lab Invest. 2022 Feb;82(1):1-5. doi: 10.1080/00365513.2021.1989714. Epub 2022 Jan 10.
This study aimed to evaluate the value of cystatin C (Cys C) in predicting the perioperative and long-term prognosis of renal transplantation (RT). The clinical data of 198 RT recipients were collected. Blood samples were obtained daily until 7 d after transplantation and then discharge day to determine the serum levels of Cys C. The receiver-operating characteristic (ROC) analysis and the area under the curve (AUC) were used to determine the diagnostic accuracy of Cys C for delayed graft function (DGF). The presence of shrunken pore syndrome (SPS) with a cystatin C-based estimate of glomerular filtration rate less than 70% of a creatinine-based estimate, was also evaluated as a prognostic factor for the development of DGF. The serum Cys C levels of patients with DGF were higher than those of the non-DGF group. Cys C showed a higher AUC (0.928) in the ROC analysis than did sCr (0.862). Compared to the non-SPS group, there were more patients diagnosed with SPS in the DGF group ( < .05). The follow-up data showed that patients diagnosed with SPS had higher levels of sCr and Cys C compared to other patients, suggesting a poor long-term prognosis. Our findings suggest that Cys C is a sensitive indicator of renal function during the perioperative period. Cys C at a concentration of 4.9 mg/L had the highest sum of sensitivity and specificity for prediction of DGF, with a sensitivity of 0.889 and a specificity of 0.8. SPS is associated with the development of DGF and the poor long-term prognosis of RT.
本研究旨在评估胱抑素 C（Cys C）在预测肾移植（RT）围手术期和长期预后中的价值。收集了 198 例 RT 受者的临床资料。在移植后第 7 天内每天采集血样，直至出院，并测定血清 Cys C 水平。采用受试者工作特征（ROC）分析和曲线下面积（AUC）确定 Cys C 对延迟移植物功能（DGF）的诊断准确性。还评估了基于胱抑素 C 的肾小球滤过率估计值低于基于肌酐的估计值的 70%的缩小孔综合征（SPS）的存在作为 DGF 发展的预后因素。DGF 患者的血清 Cys C 水平高于非 DGF 组。Cys C 在 ROC 分析中的 AUC（0.928）高于 sCr（0.862）。与非 SPS 组相比，DGF 组中更多的患者被诊断为 SPS（<0.05）。随访数据显示，与其他患者相比，被诊断为 SPS 的患者的 sCr 和 Cys C 水平更高，提示预后不良。我们的研究结果表明，Cys C 是围手术期肾功能的敏感指标。Cys C 浓度为 4.9mg/L 时，对 DGF 的预测具有最高的灵敏度和特异性，灵敏度为 0.889，特异性为 0.8。SPS 与 DGF 的发生和 RT 的不良长期预后相关。
