Kidney Health Research Collaborative, University of California, San Francisco and San Francisco VA Health Care System, San Francisco, California.
University of California, San Diego and San Diego VA Health Care System, San Francisco, California.
Kidney360. 2022 Aug 23;3(10):1807-1814. doi: 10.34067/KID.0003202022. eCollection 2022 Oct 27.
Cystatin C has been shown to be a reliable and accurate marker of kidney function across diverse populations. The 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommended using cystatin C to confirm the diagnosis of chronic kidney disease (CKD) determined by creatinine-based estimated glomerular filtration rate (eGFR) and to estimate kidney function when accurate eGFR estimates are needed for clinical decision-making. In the efforts to remove race from eGFR calculations in the United States, the National Kidney Foundation (NKF) and American Society of Nephrology (ASN) Joint Task Force recommended increasing availability and clinical adoption of cystatin C to assess kidney function. This review summarizes the key advantages and limitations of cystatin C use in clinical practice. Our goals were to review and discuss the literature on cystatin C; understand the evidence behind the recommendations for its use as a marker of kidney function to diagnose CKD and risk stratify patients for adverse outcomes; discuss the challenges of its use in clinical practice; and guide clinicians on its interpretation.
半胱氨酸蛋白酶抑制剂 C 已被证明在不同人群中均是一种可靠且准确的肾功能标志物。2012 年肾脏病：改善全球预后（KDIGO）指南建议使用半胱氨酸蛋白酶抑制剂 C 来确认基于肌酐的估算肾小球滤过率（eGFR）所确定的慢性肾脏病（CKD）的诊断，并在需要进行临床决策的准确 eGFR 估计时，用于评估肾功能。在美国，为了消除 eGFR 计算中的种族因素，国家肾脏基金会（NKF）和美国肾脏病学会（ASN）联合工作组建议增加半胱氨酸蛋白酶抑制剂 C 的可用性和临床应用，以评估肾功能。本综述总结了半胱氨酸蛋白酶抑制剂 C 在临床实践中的主要优势和局限性。我们的目标是回顾和讨论半胱氨酸蛋白酶抑制剂 C 的文献；了解其作为 CKD 诊断和风险分层标志物的使用建议背后的证据，以及其在预测不良结局方面的证据；讨论其在临床实践中的应用挑战；并指导临床医生对半胱氨酸蛋白酶抑制剂 C 的解读。
