Effect Of Calcium Dobesilate On Renal Function Assessment

OBJECTIVE:To observe the effects of calcium dobesilate on serum creatinine,cystatin,urea and estimated glomerular filtration rate by in vitro and in vivo experiments,and provide reference for clinical renal function assessment.METHODS:In vitro experiments:A total of 24 patients with CKD ?chronic kidney diseases?admitted to the Department of Geriatrics and Pediatrics of Jiangsu Provincial People's Hospital from April to August 2018 were enrolled.They were divided by the baseline serum creatinine?Cr?concentration into the low,medium and high serum Cr level groups.We collected base serum samples of three groups,added calcium dobesilate into those base serum pools to prepare a dose-response series,of which the calcium dobesilate concentrations were 0,4,8,16,32,and 64 ug/mL.Serum Cr,CysC,and Urea of each group were measured.In vivo experiments:A total of 31 patients admitted to the Department of Geriatrics and Pediatrics of Jiangsu Provincial People's Hospital fromApril to August 2018 were enrolled.According to the renal function level,they were divided into CDK1-2group,CKD3-4 group and CKD5 group.All groups were treated with calcium dobesilate for 7 days and compare creatinine?Cr?,serum cystatin?CysC?,blood urea nitrogen?Urea?and estimated glomerular filtration rate(eGFR use CKD-EPI_2012Cr-CysC?CKD-EPI_2009Scr and CKD-EPI_2012Cys)at different time points.RESULTS:In vitro experiment confirmed that when the concentration of calcium dobesilate was above 8 ug/mL,there would be a negative interference with serum Cr levels in all three groups and its interference is quantitatively dependent.The CysC and urea levels were no significant change.In vitro experiment:After taking calcium dobesilate:?1?There was no significant change in CysC and Urea in each group;?2?Cr:There was no significant change in Cr in the CKD1-2 group,Cr in the CKD3-4group was significantly increased after stopping the drug.In the CKD stage 5 group,Cr decreased significantly after administration,and significantly increased after discontinuation of the drug;?3?eGFR:CKD1-2 group had no significant change in eGFR;CKD 3-4 group eGFRCKD-EPI_2012Cr-CysC decreased significantly after stopping,eGFRCKD-EPI_2009Scr increased significantly after administration,and decreased significantly after elapse of drug and there was no significant change in eGFRCKD-EPI_2012Cys;CKD5 group eGFRCKD-EPI_2012Cr-CysC012Cr-CysC was significantly higher than drug administration,and eGFRCKD-EPI_2009Scr increased significantly after administration.After significant decline,there was no significant change in eGFRCKD-EPI_2012Cys.Conclusion:In vitro studies have shown that calcium dobesilate has a negative interference with creatinine determination,while in vivo studies have shown that in patients with CKD3-5 stage,calcium dobesilate has significant interference in the detection of Cr,CKD-EPI_2012Cr-CysC and CKD-EPI_2009Scr,but has no effect on CysC,Urea and CKD-EPI_2012CysC.Therefore,it is more accurate to use the CKD-EPI_2012Cys012Cys formula for patients who taking calcium dobesilate to evaluate renal function.