Within-person variability in kidney measures.
Within-person variability in kidney measures.
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DOI：
10.1053/j.ajkd.2012.11.048
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发表时间：
2013-05
期刊：
影响因子：
--
通讯作者：
Coresh J
中科院分区：
文献类型：
--
作者：
Selvin E;Juraschek SP;Eckfeldt J;Levey AS;Inker LA;Coresh J
我们的目标是使用国家数据量化标准和非传统肾脏测量的短期总体人内变异性。反复检查血清、尿、肾指标。第三次全国健康与营养调查（NHANES III）中年龄在18岁或以上的参与者，在间隔约18天的访问期间重复采集血液和尿液样本。标准化血清肌酐、标准化胱抑素C、β-微量蛋白（BTP）、β2-微球蛋白（B2M）、尿白蛋白和肌酐。我们计算了人内变异系数（CVw），其中包括生物变异和分析变异。我们还评估了变异性对肾小球滤过率和蛋白尿发生率降低的影响。血清胱抑素C表现出最低的短期人内变异（CVw=6.8%）。血清肌酐和B2M （CVw值分别为7.6%和8.4%）也具有较低的变异性。BTP对血清标志物的变异性最大（CVw=11.6%）。正如预期的那样，尿白蛋白和尿肌酐浓度测量表现出很高的可变性（两者的CVw均为30%），然而白蛋白-肌酐比单独测量要好得多，CVw为11.3%。这种变异性对肾小球滤过率降低的患病率的影响是中等的，与间隔18天重复应用相同的测试相比，基于单一测量定义的患病率降低了约20%。重复检测蛋白尿的效果更大，当重复检测时，蛋白尿的患病率降低了33%。只有两种测量方法可用。肾脏疾病患病率低的一般人群。我们的研究结果表明，肌酐、胱抑素C和B2M具有相似的低短期变异性。与其他血清滤过剂相比，BTP变化更大。尿白蛋白和肌酐是高度可变的，可能受益于重复评估，以减少白蛋白尿的错误分类。
Our objective was to quantify the short-term total within-person variability in standard and nontraditional kidney measures using national data. Repeat examination study of serum and urine kidney measures. Participants aged 18 or older in the Third National Health and Nutrition Examination Survey (NHANES III) who had repeat blood and urine samples collected during visits occurring ~18 days apart. Standardized serum creatinine, standardized cystatin C, β-trace protein (BTP), β2-microglobulin (B2M) and urine albumin and creatinine. We calculated the within-person coefficient of variation (CVw), which includes both biological and analytical variability. We also evaluated the impact of variability on estimates of the prevalence of reduced estimated glomerular filtration rate and albuminuria. Serum cystatin C demonstrated the lowest short-term within-person variability (CVw=6.8%). Serum creatinine and B2M (CVw values of 7.6% and 8.4%, respectively) also had low variability. BTP had the most variability of the serum markers (CVw=11.6%). As expected, urine albumin and urine creatinine concentration measurements exhibited high variability (CVw >30% for both), however the albumin-creatinine ratio performed much better than either measure alone, with a CVw of 11.3%. The effect of this variability on the prevalence of reduced estimated glomerular filtration rate was moderate, with an approximately 20% lower prevalence when defined based on single measurements compared to repeated application of the same test ~18 days apart. Repeat testing for albuminuria had a larger effect, showing a 33% lower prevalence of albuminuria when repeat testing was applied. Only two measurements available. General population with low prevalence of kidney disease. Our results suggest that creatinine, cystatin C, and B2M have similarly low short-term variability. BTP was more variable compared to the other serum filtration makers. Urine albumin and creatinine were highly variable and may benefit from repeat assessments to reduce the misclassification of albuminuria.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
120.7
作者：
de Boer, Ian H.;Rue, Tessa C.;Hall, Yoshio N.;Heagerty, Patrick J.;Weiss, Noel S.;Himmelfarb, Jonathan
通讯作者：
Himmelfarb, Jonathan
影响因子：
13.2
作者：
Koettgen, Anna;Selvin, Elizabeth;Coresh, Josef
通讯作者：
Coresh, Josef
影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
19.6
作者：
Levey, AS;Eckardt, KU;Eknoyan, G
通讯作者：
Eknoyan, G