Clinical Study Of Serum Cystatin C And Chronic Kidney Disease And Its Cardiovascular Complications

Objective:Analyze the correlation between serum cystatin C and chronic kidney disease and its cardiovascular complications,and provide new diagnostic ideas for patients with chronic kidney disease and its cardiovascular complications.Methods:A total of 317 patients with chronic kidney disease who were hospitalized in the Department of Nephrology,China-Japan Union Hospital of Jilin University from January 2019 to December 2020 were selected,and the gender,age,primary disease,previous history of hypertension and diabetes,history of smoking,and alcohol consumption were collected.History,height,weight,serum cystatin C,serum creatinine,urea,uric acid,triglycerides,total cholesterol,N-terminal brain natriuretic peptide precursor.Use IBM SPSS 20.0 software to analyze the data.All continuous variables are tested by Kolmogorov-Smirnov for normality.Measurement data conforming to the normal distribution are represented by mean ± standard deviation(),and count data are represented by frequency and percentage(n,%).)Means.Use independent sample T test,Welch analysis of variance,Games-Howell test,and Chi-square test to analyze the differences between groups;use graphpad prism drawing software to visualize the difference between each two sets of data;use Pearson or Spearman test to analyze the correlation between indicators;use Multiple linear stepwise regression analysis of the influencing factors of the index;using the receiver operating characteristic curve(ROC curve),the critical value is determined by calculating the maximum Youden index,and the sensitivity and specificity are calculated.P<0.05 indicates that the difference is statistically significant.Results:1.With the gradual decrease of GFR in CKD1-5 stage,serum cystatin C and serum creatinine are constantly increasing.In the correlation analysis of serum cystatin C and serum creatinine with e GFR,both of them were negatively correlated with e GFR.The abnormal detection rate of serum cystatin C in early CKD patients was significantly higher than that of serum creatinine.Both serum cystatin C and creatinine were negatively correlated with e GFR in early CKD,but the correlation coefficient of serum cystatin C was absolute.The value is greater.2.With the gradual decrease of GFR,the main indicators of ventricular remodeling LVDD,LVPWT,IVST,LVMI continue to increase.In the correlation analysis between serum cystatin C and the main indicators of ventricular remodeling,serum cystatin C was positively correlated with various indicators.The main indicators of ventricular remodeling were used as dependent variables,and multiple linear stepwise regression analysis was performed.The results showed that the effect of serum cystatin C on the main indicators of ventricular remodeling was statistically significant.3.The serum cystatin C of CKD patients with heart failure is higher than that of patients without heart failure.In the correlation analysis between serum cystatin C and NT-pro BNP,EF,serum cystatin C was positively correlated with NT-pro BNP,and negatively correlated with EF.The area under the ROC curve of serum cystatin C in CKD with heart failure was 0.707,P<0.05,cut-off point was 2.685,sensitivity was 0.748,and specificity was 0.589.Conclusion:1.Both serum cystatin C and serum creatinine can reflect the level of renal function in CKD1-5.2.Serum cystatin C reflects that early CKD glomerular filtration rate decline is more sensitive than creatinine,and early CKD detection of serum cystatin C is more advantageous than creatinine.3.Serum cystatin C is positively correlated with the main indicators of ventricular remodeling,suggesting the possibility of ventricular remodeling in some CKD patients.4.The serum cystatin C of CKD patients with heart failure is higher than that of patients without heart failure.Serum cystatin C can be combined with NT-pro BNP and EF to improve the diagnosis of heart failure in CKD patients.