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在老年人中使用估计的GFR与不同过标记的CKD患病率和发病率:社区动脉样硬化风险研究
Carina M Flaherty1, Aditya Surapaneni1, Jesse C Seegmiller2
1Division of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY.
Kidney medicine
|September 25, 2024
概括
在老年人中,慢性病 (CKD) 患病率和进展的估计因过标记而异. 基于赛斯塔丁C的估计显示,CKD的患病率和进展速度高于基于肌素的估计.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 流行病学 流行病学
背景情况:
- 慢性病 (CKD) 的患病率随着年龄的增长而增加.
- 肌素是估计质过率 (GFR) 的常见标志物,但其可靠性在老年人中下降.
- 很少有研究比较了老年人群中GFR估计的不同过标记.
研究的目的:
- 通过使用各种估计GFR (eGFR) 标记来调查老年人中CKD的患病率和进展情况.
- 为了比较通过肌素 (eGFRcr),囊素C (eGFRcys) 和组合标记物 (eGFRcr-cys,eGFRcr-cys-b2m) 估计的eGFR的性能.
主要方法:
- 这是一项前性观察队列研究,对65-100岁的6393名参与者进行了观察.
- 计算eGFR的方法是使用肌素,囊素C或两者加上β-2-微型血球蛋白.
- 慢性瘤进展被定义为eGFR在纵向随访期间下降30%.
主要成果:
- 平均eGFR在71.2 (eGFRcys) 到61.2mL/min/1.73m2 (eGFRcr) 之间.
- 对于所有标志物来说,CKD患病率 (eGFR < 60 mL/min/1.73m2) 与eGFRcys最高,并且随着年龄的增长而增加.
- 在8年内,eGFRcys下降率高于eGFRcr (9%),而eGFRcys下降率高于18%.
结论:
- 在老年人中,CKD患病率和进展估计取决于所使用的过标志物.
- 与基于肌素的eGFR相比,基于cystatin C的eGFR在这个人群中显示了较高的CKD流行率和进展率.
- 需要进行进一步的研究,以确定对老年人的最佳GFR估计方法.
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