Rapid assessment of renal reserve in young adults by cystatin C.
Rapid assessment of renal reserve in young adults by cystatin C.
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DOI：
10.3109/00365513.2013.765964
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发表时间：
2013
影响因子：
2.1
通讯作者：
Schwartz GJ
中科院分区：
文献类型：
--
作者：
Fuhrman DY;Maier PS;Schwartz GJ
肾脏可以增加肾小球滤过率（GFR），以响应蛋白质负荷（肾储备）。在一项健康年轻人的初步研究中，我们使用血清胱抑素C（cysC）的变化来检查肾储备。使用碘海醇单斜率血浆消失法获得肾小球滤过率。为了刺激GFR，受试者摄入含有60克蛋白质的牛肉汉堡。在蛋白负载之前和之后125-141分钟通过免疫比浊法测量CysC。发现所有受试者的碘海醇血浆消失GFR均正常，平均值为104.6 ± 9.9 mL/min/1.73 m2。每例受试者在肉食后CysC均下降。基于cysC的基线GFR估计值为98.1 ± 9.1 mL/min/1.73 m2，平均增加12.0 ± 5.2（p = 0.0003）。我们的研究表明，在年轻成人中，蛋白质负荷后血清cysC持续降低，基于cysC的估计GFR增加。需要进一步的研究，使用肾脏清除方法，以确认cysC准确地确定肾储备的慢性肾脏疾病患者和非慢性肾脏疾病患者。
The kidney can increase glomerular filtration rate (GFR) in response to a protein load (renal reserve). In a pilot study of healthy young adults we examined renal reserve using changes in serum cystatin C (cysC). Glomerular filtration rate was obtained using iohexol single slope plasma disappearance. To stimulate GFR, subjects ingested a beefburger containing 60 grams of protein. CysC was measured by immunonephelometry before and 125–141 minutes after protein loading. All subjects were found to have a normal iohexol plasma disappearance GFR with a mean of 104.6 ± 9.9 mL/min per 1.73 m2. CysC decreased in each subject after the meat meal. Baseline cysC-based estimated GFR was 98.1 ± 9.1 mL/min per 1.73 m2 with a mean increase of 12.0 ± 5.2 (p = 0.0003). Our study showed a consistent decrease in serum cysC and increase in cysC-based estimated GFR following a protein load in young adults. Further studies are needed using renal clearance methods to confirm that cysC accurately determines renal reserve in patients with and without chronic kidney disease.