Serum cystatin C is superior to serum creatinine as a marker of kidney function: A meta-analysis
Serum cystatin C is superior to serum creatinine as a marker of kidney function: A meta-analysis
复制标题
DOI：
10.1053/ajkd.2002.34487
复制
发表时间：
2002-08-01
影响因子：
13.2
通讯作者：
Stevens, G
中科院分区：
文献类型：
--
作者：
Dharnidharka, VR;Kwon, C;Stevens, G
背景资料：血清半胱氨酸蛋白酶抑制剂C（Cys C）是一种简便、准确、快速的肾小球滤过率（GFR）内源性指标，在研究和临床实践中得到了广泛应用。然而，关于Cys C优于血清肌酐（Cr）的报道相互矛盾，少数研究表明无显著差异。研究方法：我们对来自各种研究的可用数据进行了荟萃分析，以比较Cys C和Cr相对于GFR参考标准的准确性。文献检索显示截至2001年12月31日的46篇文章。我们还检索了其他8项研究的数据，并以摘要形式发表。结果如下：血清Cys C倒数的总体相关系数（r = 0.816; 95%置信区间[CI]，0.804 ~ 0.826）优于血清Cr倒数的总体相关系数（r = 0.742; 95%CI，0.726 ~ 0.758; P < 0.001），上级。类似地，1/Cys C的受试者工作特征（ROC）-曲线下面积（AUC）值与GFR的参考试验具有更大的一致性（Cys C的平均ROC曲线AUC，0.926; 95% CI，0.892 - 0.960）比1/Cr的ROC曲线AUC值（血清Cr的平均ROC曲线AUC，0.837; 95%CI，0.796至0.878; P < 0.001）。免疫荧光法测定Cys C的相关性显著高于其他测定方法（r = 0.846比r = 0.784; P < 0.001）。总结：在使用当前可用数据的荟萃分析中，血清Cys C作为通过相关性或平均ROC曲线AUC测量的GFR标志物明显优于血清Cr上级。(C)2002年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Background: Serum cystatin C (Cys C) has been proposed as a simple, accurate, and rapid endogenous marker of glomerular filtration rate (GFR) in research and clinical practice. However, there are conflicting reports regarding the superiority of Cys C over serum creatinine (Cr), with a few studies suggesting no significant difference. Methods: We performed a meta-analysis of available data from various studies to compare the accuracy of Cys C and Cr in relation to a reference standard of GFR. A bibliographic search showed 46 articles until December 31, 2001. We also retrieved data from eight other studies presented and published in abstract form. Results: The overall correlation coefficient for the reciprocal of serum Cys C (r = 0.816; 95% confidence interval [Cl], 0.804 to 0.826) was superior to that of the reciprocal of serum Cr (r = 0.742; 95% Cl, 0.726 to 0.758; P < 0.001). Similarly, receiver operating characteristic (ROC)-plot area under the curve (AUC) values for 1/Cys C had greater identity with the reference test for GFR (mean ROC-plot AUC for Cys C, 0.926; 95% CI, 0.892 to 0.960) than ROC-plot AUC values for 1/Cr (mean ROC-plot AUC for serum Cr, 0.837; 95% CI, 0.796 to 0.878; P < 0.001). Immunonephelometric methods of Cys C assay produced significantly greater correlations than other assay methods (r = 0.846 versus r = 0.784; P < 0.001). Conclusion: In this meta-analysis using currently available data, serum Cys C is clearly superior to serum Cr as a marker of GFR measured by correlation or mean ROC-plot AUC. (C) 2002 by the National Kidney Foundation, Inc.