The diagnostic value of rescaled renal biomarkers serum creatinine and serum cystatin C and their relation with measured glomerular filtration rate

作者：Pottel Hans^*; Dubourg Laurence; Schaeffner Elke; Eriksen Bjorn Odvar; Melsom Toralf; Lamb Edmund J; Rule Andrew D; Turner Stephen T; Glassock Richard J; De Souza Vandrea; Selistre Luciano; Goffin Karolien; Pauwels Steven; Mariat Christophe; Flamant Martin; Bevec Sebastjan; Delanaye Pierre; Ebert Natalie

来源：Clinica Chimica Acta, 2017, 471: 164-170.

DOI：10.1016/j.cca.2017.06.005

• Serum creatinine
• Cystatin C
• Measured GFR

Background Serum creatinine (Scr) is the major contributing variable in glomerular filtration rate (GFR) estimating equations. Serum cystatin C (ScysC) based GFR estimating (eGFR)-equations have also been developed. The present study investigates the relation between 'resealed' levels of these renal biomarkers (with reference interval of [0.67-1.33]) and measured GFR (mGFR).
Methods: We evaluated the diagnostic ability to detect impaired kidney function of the resealed renal biomarkers in 8584 subjects from 12 cohorts with measured GFR, standardized Scr and ScysC. We calculated sensitivity and specificity of the resealed biomarkers to identify kidney disease, with reference to a fixed (60 mL/min/1.73 m(2)) as well as an age-dependent threshold for mGFR.
Results: The upper reference limit of 1.33 for resealed renal biomarkers is closely related to the age-dependent threshold for defining kidney status by mGFR with sensitivity and specificity for the resealed biomarkers close to 90% for all ages. If the fixed threshold of 60 mL/min/1.73 m2 for mGFR is used, then lower specificity in children and sensitivity in older adults are observed.
Conclusions: Impaired kidney function can be diagnosed by resealed renal biomarkers instead of eGFR-equations using the fixed threshold of 1.33 for all ages, consistent with an age-dependent threshold of mGFR.

• 出版日期2017-8
• 单位UCLA; KU Leuven