Author/Editor		Hojs, Radovan; Bevc, Sebastjan; Ekart, Robert; Gorenjak, Maksimiljan; Puklavec, Ludvik
Title		Ocena glomerulne filtracije - primerjava serumskega kreatinina, serumskega cistatina C in enačb za izračun očistka kreatinina
Translated title		Estimation of the glomerular filtration rate - comparison between serum creatinine, cystatin C and calculated creatinine clearance
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 75, št. 8
Publication year		2006
Volume		str. 255-62
Language		slo
Abstract		Background With increasing emphasis on the earlier detection and management of chronic kidney disease (CKD), estimation of the glomerular filtration rate (GFR) has assumed greater importance. GFR is often estimated from serum creatinine, recently also from serum cystatin C and by Cockcroft-Gault (C&G) and Modification of diet in renal disease (MDRD) formulas. In our study different markers of GFR were compared with gold standard 51CrEDTiI cloarance. Patients and We included 468 patients with CKD stages 2-5 (216 women and 252 men, average age methods 60.4 ± 14.3 years), who performed 51CrEDTA clearance. In each patient, serum creatinine and cystatin C were determined, creatinine clearance was calculated using C&G and MDRD formulas. Results We found significant correlation between 51CrEDTA clearance with serum creatinine (r = -0.889, reciprocal of serum creatinine (r = 0.866), serum cystatin C (r = -0.902), reciprocal of serum cystatin C (r = 0.901) and with calculated creatinine clearance from C&G (r = 0.808) and MDRD formulas (r = 0.90Z). The ROC curve analysis (cut-off for GFR 60 ml/min/1.73m2) showed that serum cystatin C had higher diagnostic accuracy than serum creatinine (P = 0.006) and calculated creatinine clearance from C&G formula (P = 0.004). No difference in diagnostic accuracy was found between serum cystatin C and creatinine clearance calculated from the MDRD formula. Conclusions Serum cystatin C is a better marker of GFR and has a higher diagnostic accuracy than serum creatinine and calculated creatinine clearance from C&G formula. No difference in diagnostic accuracy was found between serum cystatin C and creatinine clearance calculated from the MDRD formula.
Summary		Izhodišča V želji po zgodnejšem odkrivanju in zdravljenju kronične ledvične bolezni (KLB) je ocena glomerulne filtracije (GF) pridobila na pomenu. Za oceno GF najpogosteje uporabljamo serumsko koncentracijo kreatinina, v zadnjem času tudi cistatina C ter Cockcroft-Gaultovo (C&G) enačbo in enačbo MDRD (Modification of Diet in Renal Disease) raziskave za izračun očistka kreatinina. V naši raziskavi smo med seboj primerjali različne označevalce GF glede na zlati standard, očistek 51CrEDTA. Bolniki in metode Vključili smo 468 bolnikov s stopnjo 2 do 5 KLB (216 žensk in 252 moških; povprečna starost 60,4 ± 14,3 leta), ki so imeli določen očistek 51CrFDTA. Ob odvzemu krvi za določitev očistka 51CrEDTA smo izmerili tudi serumsko koncentracijo kreatinina in cistatina C ter na podlagi C&G enačbe in enačbe MDRD raziskave izračunali kreatininski očistek. Rezultati Ugotovili smo povezavo med očistkom 51CrEDTA in serumsko koncentracijo kreatinina (r =-0,889), recipročno vrednostjo serunaskega kreatinina (r = 0,866), serumsko koncentracijo cistatina C (r = -0,902), recipročno vrednostjo cistatina C (r = 0,901) in očistkom kreatinina, izračunanega tako po enačbi C&G (r = 0, 808) kot po enačbi raziskave MDRD (r = 0,901). Ugotovili smo (ROC krivulje) višjo diagnostično zanesljivost meritev serumskega cistatina C v primerjavi z diagnostično zanesljivostjo meritev serumskega kreatinina (P = 0, 006 in očistka kreatinina, izračunanega po enačbi C&G (P = 0, 004) pri mejni vrednosti GF 60 ml/min/1,73m2. Diagnostična zanesljivost serumskega cistatina C je bila v primerjavi z diagnostično zanesljivostjo enačbe raziskave MDRD statistično neznačilna.
Descriptors		GLOMERULAR FILTRATION RATE CYSTATINS CREATININE METABOLIC CLEARANCE RATE KIDNEY DISEASES ROC CURVE