在门诊脏移植接受者中,Jaffe和酶方法之间的血清肌素差异的影响
Kristina Boss1, Susanne Stolpe2, André Müller3
1Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany.
Journal of clinical medicine
|October 26, 2024
概括
血清肌素 (SCr) 测量方法的差异影响移植接受者 (KTRs) 的病阶段. 在超过10%的门诊KTR中,Jaffe与酶性SCr测试改变了慢性病 (CKD) 的阶段分配.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 移植医学 移植医学
背景情况:
- 血清肌素 (SCr) 测定 (Jaffe与酶) 可以产生不同的结果,可能会影响病的诊断和分期.
- 在移植接受者 (KTRs) 中,这些SCr测量差异的临床意义尚不清楚.
- 在KTR中精确的移植功能评估依赖于精确的SCr测量.
研究的目的:
- 量化Jaffe与酶性SCr测量方法对KTRs病阶段的影响.
- 评估Jaffe和酶性SCr测量之间的一致性,以及它们在KTRs中的推算质过率 (eGFR) 的推算.
- 为了确定慢性病 (CKD) 阶段变化的频率,由于KTRs中的SCr方法差异.
主要方法:
- 从成人门诊KTR (2020年1月 - 2023年10月) 中对平行Jaffe和酶性SCr测量的分析.
- 使用Bland-Altman图表来评估SCr方法之间的一致性和一致性极限 (LoA).
- 使用CKD-EPI 2009,EKFC和BIS1 (对于70岁以上的患者) 公式计算eGFR.
主要成果:
- 分析了1243个KTR的12081个测量结果.
- 贾菲的Scr平均比酶的Scr高0.03毫克/分升 (LoA -0.16;0.21毫克/分升).
- 来自雅菲SCr的eGFR平均低于来自酶SCr的1.9 mL/min/1.73 m2 (LoA -9.5;5.7 mL/min/1.73 m2).
- 13%的测量结果显示CKD的不同阶段,最常见的是G2/G3a和G3a/G3b之间.
- 在应用的eGFR公式 (EKFC,BIS1) 中,CKD分期差异相似.
结论:
- 在超过10%的门诊KTR中,SCr测量方法的差异显著影响CKD分期.
- 对CKD分期的观察效应在不同的eGFR计算公式中是一致的.
- 这些发现凸显了在KTR管理中标准化方法或意识到SCr试验变异性的重要性.
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