基于胱抑素C和肌酐的估计肾小球滤过率与肌萎缩侧索硬化症患者生存率的差异：一项基于人群的队列研究。

The difference between cystatin C- and creatinine-based estimated glomerular filtration rate and survival in amyotrophic lateral sclerosis: a population-based cohort study.

作者信息

Zhu Yahui, Bai Jiongming, Wang Hongfen, Li Mao, Yang Fei, Pang Xinyuan, Du Rongrong, Zhao Jiarui, Huang Xusheng, Cui Fang

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.

出版信息

Neurodegener Dis Manag. 2025 Sep 2:1-9. doi: 10.1080/17582024.2025.2554224.

DOI:10.1080/17582024.2025.2554224

PMID:40898684

Abstract

OBJECTIVES

We investigated the relationship between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFRdiff) and amyotrophic lateral sclerosis (ALS) outcomes.

METHODS

We enrolled ALS patients diagnosed between January 2014 and December 2019. Experienced neurologists followed up the participants until January 2022. Absolute difference between eGFR (eGFRabdiff) and relative difference between eGFR (eGFRrediff) were obtained. Cox proportional hazard models were used to evaluate the relationship between eGFRdiff and ALS survival.

RESULTS

Negative eGFRabdiff were common in the patients (74.7%). For each SD increase of eGFRabdiff, the risk of poor prognosis for ALS patients decreased by 1.9% (HR, 0.981; 95% CI, 0.973-0.989). For each 10% increment in eGFRrediff, the risk of poor prognosis for ALS patients decreased by 17.7% (HR, 0.823; 95% CI, 754-0.898).

CONCLUSIONS

We found that large eGFRdiff was associated with poor prognosis in ALS. Monitoring eGFRdiff in ALS population facilitates prognostic stratification assessment and precise management.

摘要

目的

我们研究了基于胱抑素C和肌酐的估计肾小球滤过率（eGFRdiff）与肌萎缩侧索硬化症（ALS）预后之间的关系。

方法

我们纳入了2014年1月至2019年12月期间确诊的ALS患者。经验丰富的神经科医生对参与者进行随访直至2022年1月。获取eGFR的绝对差值（eGFRabdiff）和相对差值（eGFRrediff）。使用Cox比例风险模型评估eGFRdiff与ALS生存之间的关系。

结果

患者中eGFRabdiff为负值很常见（74.7%）。eGFRabdiff每增加1个标准差，ALS患者预后不良的风险降低1.9%（风险比[HR]，0.981；95%置信区间[CI]，0.973 - 0.989）。eGFRrediff每增加10%，ALS患者预后不良的风险降低17.7%（HR，0.823；95%CI，754 - 0.898）。