Age- and sex-specific reference limits for creatinine, cystatin C and the estimated glomerular filtration rate
Age- and sex-specific reference limits for creatinine, cystatin C and the estimated glomerular filtration rate
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DOI：
10.1515/cclm.2011.788
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发表时间：
2012-05-01
影响因子：
6.8
通讯作者：
Nauck, Matthias
中科院分区：
文献类型：
--
作者：
Hannemann, Anke;Friedrich, Nele;Nauck, Matthias
背景：慢性肾脏病患者的早期发现非常重要。本研究制定了 25-65 岁一般人群健康受试者的血清肌酐和血清胱抑素 C 浓度以及估计肾小球滤过率 (eGFR) 的参考限值。 方法：本研究定义了一个参考人群，其中包括来自波美拉尼亚健康研究首次随访的 985 名受试者。血清肌酐采用改良的动态贾菲法测量。血清胱抑素 C 通过比浊法测定。 eGFR 分别根据 Cockcroft-Gault (eGFR(CG)) 和肾病饮食改良 (eGFR(MDRD)) 方程从血清肌酐计算，以及根据 Larsson 公式 (eGFR(Larsson)) 从血清胱抑素 C 计算。非参数分位数回归用于估计参考限。对于血清肌酐和血清胱抑素 C，选择第 95 个百分位数，对于 eGFR(CG)、eGFR(MDRD) 和 eGFR(Larsson)，选择第 5 个百分位数作为参考限值。所有数据均经过加权，以反映 2008 年德国人口的年龄和性别结构。 结果：血清肌酐（男性：1.11-1.23 mg/dL；女性：0.93-1.00 mg/dL）和血清胱抑素 C 水平（男性：0.92-1.04 mg/L；女性：0.84-1.02 mg/L）的参考限值随着年龄的增长而增加。 eGFR 的参考限值随着年龄的增加而降低（eGFR(CG) 男性：106.0-64.7 mL/min，女性 84.4-57.9 mL/min；eGFR(MDRD) 男性：82.5-62.2 mL/min/1.73 m(2)，女性 75.0-58.2 mL/min/1.73 m(2)；eGFR(Larsson) 男性： 85.5-72.9 mL/min，女性 94.5-75.7 mL/min）。结论：本研究基于分位数回归模型提出了五种肾功能测量值的年龄和性别特异性参考限值。
Background: Early detection of patients with chronic kidney disease is of great importance. This study developed reference limits for serum creatinine and serum cystatin C concentrations and for the estimated glomerular filtration rate (eGFR) in healthy subjects from the general population aged 25-65 years.Methods: This study defined a reference population including 985 subjects from the first follow-up of the Study of Health in Pomerania. Serum creatinine was measured with a modified kinetic Jaffe method. Serum cystatin C was measured with a nephelometric assay. The eGFR was calculated from serum creatinine according to the Cockcroft-Gault (eGFR(CG)) and the Modification of Diet in Renal Disease (eGFR(MDRD)) equation, respectively, as well as from serum cystatin C according to the formula by Larsson (eGFR(Larsson)). Non-parametric quantile regression was used to estimate the reference limits. For serum creatinine and serum cystatin C the 95th percentile and for eGFR(CG), eGFR(MDRD) and eGFR(Larsson) the 5th percentile were selected as reference limits. All data was weighted to reflect the age-and sex-structure of the German population in 2008.Results: The reference limits for serum creatinine (men: 1.11-1.23 mg/dL; women: 0.93-1.00 mg/dL) and serum cystatin C levels (men: 0.92-1.04 mg/L; women: 0.84-1.02 mg/L) increased with advancing age. The reference limits for eGFR decreased with increasing age (eGFR(CG) men: 106.0-64.7 mL/min, women 84.4-57.9 mL/min; eGFR(MDRD) men: 82.5-62.2 mL/min/1.73 m(2), women 75.0-58.2 mL/min/1.73 m(2); eGFR(Larsson) men: 85.5-72.9 mL/min, women 94.5-75.7 mL/min).Conclusions: This study presents age-and sex-specific reference limits for five measures of renal function based on quantile regression models.