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囊素C作为急性和慢性疾病中的GFR估计标记:系统性审查
Ogechi M Adingwupu1, Ernesto Rodolpho Barbosa2, Paul M Palevsky3
1Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, MA.
Kidney medicine
|November 6, 2023
概括
基于肌素的GFR估计方程在患病患者中通常是不准确的. 结合肌素和囊素C (eGFRcr-cys) 改善了功能估计在一些条件,如癌症和艾滋病毒,表明囊素C测试的潜在好处.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 内部医学 内部医学
背景情况:
- 在患有急性或慢性疾病的患者中,基于肌素的估计质过率 (eGFRcr) 方程表现出不准确.
- 在这些人群中,基于囊素C (eGFRcys) 和联合肌素-囊素C (eGFRcr-cys) 方程的性能仍未得到充分研究.
研究的目的:
- 系统地审查和评估eGFRcr,eGFRcys和eGFRcr-cys方程的准确性,与在急性或慢性疾病的成人和儿科患者群体中测量的GFR (mGFR) 相比.
主要方法:
- 2011年以来发表的研究的系统审查,通过PubMed和专家来源确定.
- 纳入标准侧重于将eGFRcr,eGFRcys和eGFRcr-cys与mGFR使用标准化试验进行比较,不包括特定群体,如仅患有CKD或仅患有糖尿病的人群.
主要成果:
- 包括26项涉及临床人群的研究 (癌症,艾滋病毒,肝硬化,肝移植,心力衰竭,神经肌肉疾病,危急疾病,肥胖症).
- 在患有癌症,艾滋病毒和肥胖的人群中,eGFRcr-cys表现出比eGFRcr或eGFRcys更高的准确性.
- 肝硬化,肝移植,心力衰竭,神经肌肉疾病和危急疾病的表现不一致,许多研究显示表现不佳,并表明需要更频繁的mGFR.
结论:
- 结合的肌素-囊素C (eGFRcr-cys) 方程可以提高各种急性和慢性疾病中的GFR估计,支持囊素C测量的实用性.
- 观察到的性能变化凸显了需要仔细考虑GFR估计方法和在某些临床场景中可能更频繁的测量GFR的需要.
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