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年龄、性别及慢性肾脏病对日本患者尿肌酐排泄的影响

Effect of age, sex, and chronic kidney disease on urinary creatinine excretion in Japanese patients.

作者信息

Yasui Shigehiro, Horino Taro, Mitani Keita, Terada Yoshio, Okuhara Yoshiyasu, Hatakeyama Yutaka

机构信息

Center of Medical Information Science, Kochi Medical School, Kochi University, KohasuNankoku, Kochi, Oko-Cho, 783-8505, Japan.

Department of Endocrinology, Metabolism, and Nephrology, Kochi Medical School, Kochi University, KohasuNankoku, Kochi, Oko-Cho, 783-8505, Japan.

出版信息

Clin Exp Nephrol. 2025 Jan;29(1):83-90. doi: 10.1007/s10157-024-02569-5. Epub 2024 Sep 27.

Abstract

BACKGROUND

Urinary creatinine levels are used to estimate the excretion rates of certain analytes from the respective analyte-to-creatinine ratios. We clarified the influence of age and sex on estimated daily urinary creatinine excretion (eUCrE) based on the urinary creatinine level and daily urine volume.

METHODS

All inpatients aged ≥ 18 years who attended the Kochi Medical School Hospital with serum and urinary creatinine measurement results were enrolled. Serum and urinary creatinine concentrations were extracted from the database and fluctuations with sex and age were investigated. The eUCrE was calculated for patients with early morning spot urine protein excretion (UPE), and daily urine volume was measured on the same day.

RESULTS

Overall, 643 participants (322 men, 321 women) were enrolled. The eUCrE levels of men and women aged 18 - 64 and 18 - 44 years, respectively, significantly exceeded 1 g/day. Those of women aged 65-74 and ≥ 75 years were significantly lower than 1 g/day. Each age group was further categorised into Groups A (patients with eGFR ≥ 30 mL/min/1.73 m and UPE < 0.5 g/gCr), B (eGFR ≥ 30 mL/min/1.73 m and UPE ≥ 0.5 g/gCr), and C (eGFR < 30 mL/min/1.73 m and UPE ≥ 0.5 g/gCr). The eUCrE levels were the highest in Group A, followed by Groups B and C.

CONCLUSION

This study revealed age-, sex-, and renal function-related biases in adjusted values using urinary biomarkers, including proteinuria and creatinine ratio.

摘要

背景

尿肌酐水平用于根据各自的分析物与肌酐比值估算某些分析物的排泄率。我们基于尿肌酐水平和每日尿量,阐明了年龄和性别对估计的每日尿肌酐排泄量(eUCrE)的影响。

方法

纳入所有年龄≥18岁、在高知医科大学医院就诊且有血清和尿肌酐测量结果的住院患者。从数据库中提取血清和尿肌酐浓度,并研究其随性别和年龄的波动情况。对清晨即时尿蛋白排泄量(UPE)患者计算eUCrE,并在同一天测量每日尿量。

结果

总共纳入了643名参与者(322名男性,321名女性)。18 - 64岁男性和18 - 44岁女性的eUCrE水平分别显著超过1 g/天。65 - 74岁和≥75岁女性的eUCrE水平显著低于1 g/天。每个年龄组进一步分为A组(估算肾小球滤过率[eGFR]≥30 mL/min/1.73 m²且UPE<0.5 g/gCr的患者)、B组(eGFR≥30 mL/min/1.73 m²且UPE≥0.5 g/gCr的患者)和C组(eGFR<30 mL/min/1.73 m²且UPE≥0.5 g/gCr的患者)。eUCrE水平在A组中最高,其次是B组和C组。

结论

本研究揭示了使用包括蛋白尿和肌酐比值在内的尿生物标志物进行校正值时,存在与年龄、性别和肾功能相关的偏差。

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