GFR is better estimated by considering both serum cystatin C and creatinine levels
GFR is better estimated by considering both serum cystatin C and creatinine levels
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DOI：
10.1007/s00467-006-0145-z
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发表时间：
2006-09-01
影响因子：
3
通讯作者：
Chatelut, Etienne
中科院分区：
文献类型：
--
作者：
Bouvet, Yann;Bouissou, Francois;Chatelut, Etienne
血清胱抑素 C (cysC) 是肾小球滤过率 (GFR) 的潜在标志物，但在儿童中产生了相互矛盾的报告。进行了一项前瞻性研究，以评估将 cysC 与血清肌酐 (SCr) 以及人口统计学和形态学特征一起考虑的益处，以更好地估计 Cr-51-乙二胺四乙酸 (EDTA) 清除率 (CL)，即 GFR。使用非线性混合效应模型 (NONMEM) 程序根据群体药代动力学方法对 100 名儿童或年轻人（范围：1.4-22.8 岁）的血浆 Cr-51-EDTA 数据进行分析。将实际 CL 与根据不同协变量方程预测的 CL 进行比较。最佳协变量方程（+/- 95% 置信区间）为：GFR (ml/min)=63.2(+/- 3.4)。 [(SCr (μM)/96)(-0.35 (+/- 0.20))] 。 [(cysC (mg/l)/1.2)(-0.56 (+/- 0.19))] 。 [（体重（公斤）/45）（0.30（+/- 0.17））] 。 [年龄（岁）/14)(0.40 (+/- 0.16))]。与施瓦茨方程相比，该方程具有更小的偏差和更精确的估计。如果与数学公式中的其他协变量一起考虑，CysC 可以改善儿童 GFR 的估计。
Serum cystatin C (cysC) is a potential marker of the glomerular filtration rate (GFR) that has generated conflicting reports in children. A prospective study was conducted to assess the benefit of considering cysC together with serum creatinine (SCr) and demographic and morphologic characteristics to better estimate the Cr-51-ethylenediaminetetraacetate (EDTA) clearance (CL), i.e., the GFR. Plasma Cr-51-EDTA data from 100 children or young adults (range: 1.4-22.8 years old) were analyzed according to the population pharmacokinetic approach by using the nonlinear mixed effects model (NONMEM) program. The actual CL was compared to the CL predicted according to different covariate equations. The best covariate equation (+/- 95% confidence interval) was: GFR (ml/min)=63.2(+/- 3.4) . [(SCr (mu M)/96)(-0.35 (+/- 0.20))] . [(cysC (mg/l)/1.2)(-0.56 (+/- 0.19))] . [(body weight (kg)/45)(0.30 (+/- 0.17))] . [age (years)/14)(0.40 (+/- 0.16))]. This equation was associated with a less biased and more precise estimation than the Schwartz equation. CysC improves the estimation of the GFR in children if considered with other covariates within the mathematical formula.