Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment
Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment
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DOI：
10.1053/ajkd.2000.8237
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发表时间：
2000-07-01
影响因子：
13.2
通讯作者：
Darnell, A
中科院分区：
文献类型：
--
作者：
Coll, E;Botey, A;Darnell, A
胱抑素C是一种非糖基化的碱性蛋白质，由所有研究的有核细胞以恒定速率产生。它由肾小球自由过滤，主要在肾小管中分解代谢（不作为完整分子分泌或重吸收）。由于血清半胱氨酸蛋白酶抑制剂C浓度与年龄、性别和肌肉质量无关，因此与血清肌酸酐水平相比，它被认为是肾小球滤过率（GFR）的改善标志物。我们将血清胱抑素C水平与GFR的其他标志物（如血清肌酐水平和肌酐清除率）进行比较，并基于碘125标记的碘酞酸盐（I-125-碘酞酸盐）清除率（I-125-ICI）（用作GFR的金标准）分析其变化。根据I-125-ICI对肾功能受损患者的两种不同GFR标志物的浓度进行分类。20名肾功能正常的个体（I-125-ICI，128 +/- 23 mL/min/1.73 m（2））被用作对照组。血清胱抑素C水平的敏感性（93.4%）高于血清肌酐水平（86.8%）。此外，与血清肌酐水平（92.15%）相比，肾功能受损患者（100%）的血清胱抑素C值升高比例最大。当GFR为88 mL/min/1.73 m2时，血清胱抑素C水平开始升高至高于正常值，而当GFR为75 mL/min/1.73 m2时，血清肌酐水平开始升高。这些数据表明，血清胱抑素C的测量可能有助于估计GFR，特别是检测GFR的轻度降低，因此在早期治疗至关重要的各种肾脏疾病的早期肾功能不全的检测中可能是重要的。(C)2000年由国家肾脏基金会，公司。
Cystatin C is a nonglycosylated basic protein produced at a constant rate by all investigated nucleated cells. It is freely filtered by the renal glomeruli and primarily catabolized in the tubuli (not secreted or reabsorbed as an intact molecule). Because serum cystatin C concentration is independent of age, sex, and muscle mass, it has been postulated to be an improved marker of glomerular filtration rate (GFR) compared with serum creatinine level. We compared serum cystatin C level with other markers of GFR, such as serum creatinine level and creatinine clearance, and analyzed their variations based on iothalamate labeled with iodine 125 (I-125-iothalamate) clearance (I-125-ICI), used as the gold standard for GFR. The concentrations of the two different markers of GFR in patients with impaired renal function were classified according to I-125-ICI. Twenty individuals with normal renal function (I-125-ICI, 128 +/- 23 mL/min/1.73 m(2)) were used as the control group. Serum cystatin C level showed a greater sensitivity (93.4%) than serum creatinine level (86.8%). Also, serum cystatin C showed the greatest proportion of increased values in patients with impaired renal function (100%) compared with serum creatinine level (92.15%). Serum cystatin C levels started to increase to greater than normal values when GFR was 88 mL/min/1.73 m(2), whereas serum creatinine level began to increase when GFR was 75 mL/min/1.73 m2. These data suggest that measurement of serum cystatin C may be useful to estimate GFR, especially to detect mild reductions in GFR, and therefore may be important in the detection of early renal insufficiency in a variety of renal diseases for which early treatment is critical. (C) 2000 by the National Kidney Foundation, Inc.