Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children- A meta-analysis
Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children- A meta-analysis
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DOI：
10.1016/j.clinbiochem.2006.10.026
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发表时间：
2007-03-01
影响因子：
2.8
通讯作者：
Kirkpatrick, Carl M. J.
中科院分区：
文献类型：
--
作者：
Roos, Juliana F.;Doust, Jenny;Kirkpatrick, Carl M. J.
目的：方法：检索MEDLINE和EMBASE（1984年1月至2006年2月），比较CysC与SCr的诊断准确性进行系统评价。研究包括：i）评估CysC对公认的“金标准”方法，用于确定GFR使用受试者工作特征（ROC）曲线分析和ii）包括数据，可以提取到一个2 × 2的表。结果：搜索确定了27个人群组在24项研究（n=2007），比较诊断准确性CysC与SCr。Moses-Littenberg线性回归模型预测肾功能损害的诊断优势比（DORs）为CysC 3.99（3.41-4.57），SCr 2.79（2.12-3.46）。然而，生物标志物的合并DOR的置信区间重叠。CysC（临界值在0.9和1.4 mg/L之间）对肾功能损害（通过菊粉测定的GFR为60-79 mL/min/1.73 m（2）测量）的能力在怀疑有肾功能损害的患者中是巨大的和决定性的。(c)2007年由加拿大临床化学家协会出版。爱思唯尔公司出版All rights reserved.
Objectives: To perform a systematic review comparing the diagnostic accuracy of CysC with SCr.Methods: MEDLINE and EMBASE (January 1984-February 2006) were searched. Studies included i) evaluated CysC against a recognised 'gold standard' method for determining GFR using a receiver operating characteristics (ROC) curve analysis and ii) included data that could be extracted into a 2 x 2 table.Results: The search identified 27 population groups in 24 studies (n=2007) that compared the diagnostic accuracy of CysC with SCr. The diagnostic odds ratios (DORs) (95% CI) of predicting renal dysfunction derived from a Moses-Littenberg linear regression model were 3.99 (3.41-4.57) for CysC and 2.79 (2.12-3.46) for SCr.Conclusion: The diagnostic accuracy for impaired renal function favours CysC. However, the confidence intervals for the pooled DORs for the biomarkers overlap. The ability of CysC (cut-off values between 0.9 and 1.4 mg/L) to rule in renal impairment (as measured by inulin-determined GFR of 60-79 mL/min/1.73 m(2)) in persons in whom this is suspected is large and conclusive. (c) 2007 Published by The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.