Is cystatin C a better marker than creatinine for evaluating residual renal function in patients on continuous ambulatory peritoneal dialysis?
| Autor: | Zhibin Li, Xiao Yang, Xueqing Yu, Xueqin Wang, Ruixi Li, Jinjin Fan, Jianxiong Lin, Zhewen Zhong, Qiongqiong Yang, Haiping Mao |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Urology Renal function Urine Kidney Function Tests Sensitivity and Specificity Body Mass Index Peritoneal dialysis chemistry.chemical_compound Peritoneal Dialysis Continuous Ambulatory Internal medicine medicine Humans Cystatin C Urine Specimen Collection Transplantation Creatinine biology business.industry Continuous ambulatory peritoneal dialysis Area under the curve Middle Aged Endocrinology ROC Curve chemistry Nephrology biology.protein Female Kidney Diseases Hemodialysis business Algorithms Biomarkers Follow-Up Studies |
| Zdroj: | Nephrology Dialysis Transplantation. 26:3358-3365 |
| ISSN: | 1460-2385 0931-0509 |
| Popis: | Background Current clinical assessments of residual renal function (RRF) for continuous ambulatory peritoneal dialysis (CAPD) patients usually require 24 h of urine collection, which is sometimes difficult for patients and contributes to random errors. Objective. Our study aims to investigate whether serum cystatin C (CysC) can serve as a better marker of RRF than serum creatinine (Cr) in CAPD and to develop a formula to estimate RRF with CysC levels. Methods One hundred and sixty CAPD patients from a single dialysis unit were randomly divided into modeling (n(1) = 120) and validation (n(2) = 40) groups. RRF was assessed as the average of the renal clearances of urea and creatinine. We then derived RRF formulas based on the CysC and Cr levels from the modeling group and validated them by comparison with a published CysC-based equation and Modification of Diet in Renal Disease formula. Results CysC levels were inversely related to RRF, Kt/V(urea) and total weekly Ccr but were unrelated to age, gender, body mass index, diabetes or peritoneal clearance. The RRF formulas derived from CysC and Cr were (sinh(ln(6.736-0.566 CysC)))(2) and (sinh(ln(6.097-0.265 Cr)))(2), respectively. When applied to the validation group, the estimated RRF based on CysC (2.8 ± 1.2 mL/min/1.73 m(2)) was similar to that of on Cr (2.8 ± 1.3 mL/min/1.73 m(2)) and the measured RRF (2.9 ± 1.7 mL/min/1.73 m(2)). The CysC formula showed a small bias, with the best 30 and 50% accuracy and had a larger area under the curve and higher sensitivity and specificity when compared to the Cr formula and other formulas. Conclusion Serum CysC may be a good marker for the estimation of RRF in CAPD patients. The derived CysC formula may be used to reliably estimate RRF in CAPD patients without the need for collection of 24 h urine. |
| Databáze: | OpenAIRE |
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