基于酸的C基和基于肌的eGFR之间的差异.
Danielle K Farrington1, Aditya Surapaneni2,3, Kunihiro Matsushita2
1Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
概括
囊素C和基于肌素的估计球过率 (eGFR) 之间的差异很常见. 比eGFRcr低的eGFRcys表明脏健康状况较差,死亡和不良结果风险增加.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 流行病学 流行病学
背景情况:
- 最近的指导建议增加使用cystatin C来估计膜过率 (GFR).
- 基于肌素 (eGFRcr) 和基于囊素C (eGFRcys) 估计的GFR (eGFR) 之间的差异可能表明仅靠肌素估计的GFR不准确.
- 了解大型eGFR差异的风险因素和临床影响至关重要.
研究的目的:
- 调查与显著的eGFR差异相关的风险因素.
- 确定这些差异对不良健康结果的临床影响.
主要方法:
- 对社区动脉样硬化风险研究 (Atherosclerosis Risk in Communities Study) 的数据进行分析,这是一项长达25年的前性队列研究.
- 定义为eGFRcys的eGFR差异比eGFRcr低或高30%.
- 使用回归和考克斯模型评估与参数的关联以及长期结果 (衰竭,AKI,心力衰竭,死亡).
主要成果:
- 在研究期间,EGFRcys比eGFRcr低30%的个体比例从7%增加到23%.
- 较低EGFRcys的危险因素包括年龄,女性性别,非黑人种族,更高的EGFRcr,更高的BMI,体重减轻和吸烟.
- 低EGFRcys的个体表现出更多的贫血,更高的尿酸,FGF23和酸水平,以及死亡,功能衰竭,AKI和心力衰竭的风险增加.
结论:
- 与eGFRcr相比,较低的eGFRcys与较差的脏相关实验室结果有关.
- 这种差异意味着健康不良结果的风险更高,包括死亡率和功能衰竭.
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