| Objective:Chronic kidney disease(CKD) has been one of the diseases that threaten human's lives. It is important to estimating the changes of renal function accurately and early. Glomerular Filtration Rate (GFR) is one of the important renal function index. In this study we compared serum Cystatin C (Cys-C) and serum creatinine (Scr) with GFR measured by two plasma samples clearance of 99mTc-DTPA (mGFR). To establish an equation based on Cys-C (eGFR). To evaluat the value of equations based on Cys C and Scr of GFR in patients with chronic kidney disease.Methods:There were 126 patients with chronic kidney disease in the study collected from May 2009 to Jan 2010,including female 73,male 53,the age from 18 to 81,average 52.19±16.21 years old. All the patients were consistent with the chronic renal disease definition of the American CKD and the guide of K/DOQI, and without the conditions like the acute kidney disease, acute renal dysfunction, graveness heart failure and absence of limbs. The sex,age,height and weight of the patients were recorded. GFR was measured by two plasma samples clearance of 99mTc-DTPA (mGFR), serum Cys C and Scr concentration were detected by particle enhanced transmission immunonepholemetric(PETIA) and Jaffet in automatic biochemical analyzer.1. All the data were demonstrated in the form of (?)±s, the serum Cys-C and Scr values were compared with mGFR( as a golden standard), using Person correlation analysis and receiver operating characteristic curve(ROC curve),P<0.05 were considered to be statistical significance.2. The new equation(eGFR) between Cys-C and mGFR was developed by using SPSS curve estimation in patients collected before Nov 2009 (including female 41,male 51,mean 52.74±15.78 years old) 3. eGFR,eGFR1 (bbreviated MDRD equation) and eGFR2 (C&G equation) were compared with mGFR in 34 remaining patients (including female 12,male 22,average 50.71±17.50 years old). eGFR1 and eGFR2 were recommend by K/DOQI respectively. Paired-Samples T Test were used, P<0.05 were considered to be statistical significance.Results:The mean values in serum Cys C, Scr and mGFR were 1.49±0.86mg/L, 173.74±207.91mmol/L,54.55±33.32ml/min/1.73m2 in 126 patients respectively.1. There were negative correlations between Cys-C ,Scr and mGFR. The correlation between Cys C and mGFR was better than it between Scr and mGFR, the correlation coefficient were -0.72 and -0.60 respectively (P<0.05). When mGFR<90 ml/min/1.73m2 and mGFR<60 ml/min/1.73m2 were the cutoff values respectively, the area under the curve about Cys-C was better than that about Scr did, they were 0.931 versus 0.88, and 0.95 versus 0.936. When mGFR<30 ml/min/1.73m2 was the cutoff value, the areas under the curve about Cys-C and Scr were 0.975 and 0.983. So we can get conclusion that the Cys-C may be more better than Scr in detecting the changes of GFR earlier.2. A new equation eGFR=63.47×(Cys-C) -1.37 was found. 3. eGFR, eGFR1 eGFR2 and mGFR were49.71±27.90ml/min/1.73m2,66.49±42.17ml/min/1.73m2, 56.59±35.26ml/min/1.73m2,49.52±29.35ml/min/1.73m2 respectively. There were good correlations between eGFR,eGFR,eGFR2 and mGFR, as the correlation coefficient were 0.921,0.911 and 0.942. But only no statistic difference between eGFR and mGFR.Conclusion: 1. The serum Cys-C was a good index in evaluating GFR, and more sensitive than Scr did in evaluating GFR earlier. 2. The formula based on Cys-C GFR=63.47×(Cys-C)-1.37 was found. 3. eGFR based on Cys-C was more precise than eGFR1 and eGFR2 from abbreviate MDRD and C&G based on Scr in estimating GFR in patients with Chronic kidney disease.
|
PDF Full Text Request