在常规临床实践中,基于肌素和囊素C的估计GFR和不良临床结果之间的不一致
Juan-Jesús Carrero1, Edouard L Fu2, Yingying Sang3
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Nephrology, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
概括
常规的囊素C检测显示,许多患者估计的淋巴细胞过率 (eGFR) 低于基于肌素的估计. 这种eGFR差异与增加不良结果的风险有关,包括功能衰竭和心血管事件.
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:
- 估计的淋巴细胞过率 (eGFR) 对于临床决策至关重要.
- 基于肌的eGFR (eGFRcr) 可能并不总是准确的.
- 当eGFRcr不足时,建议使用基于cystatin C的eGFR (eGFRcys).
研究的目的:
- 在现实环境中调查eGFRcys和eGFRcr之间的差异的流行率和程度.
- 评估这些eGFR差异与不良临床结果的关联.
主要方法:
- 在瑞典斯德哥尔摩 (2010-2018) 的158,601名成年人的观察研究.
- 同时测量肌素和囊素C.
- 分析eGFR差异 (eGFRdiff) 和使用多变量考克斯回归结果的相关性.
主要成果:
- eGFRcys和eGFRcr之间的不一致是常见的 (65%的人有较低的eGFRcys).
- 显著降低eGFRcys (eGFRcys>27%低于eGFRcr) 的患者患有AKI,KFRT,ASCVD,心力衰竭和死亡的风险更高.
- 相反,正面的eGFRdiff表示风险较低.
结论:
- 与eGFRcr相比,常规的cystatin C测试确定了大量患有较低eGFRcys的患者.
- 这些差异与严重不良健康结果的风险增加有关.
- eGFRcys提供了超越eGFRcr.的宝贵预后信息.
相关概念视频
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