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A Comparison between Serum Cystatin C and Creatinine in Estimation of Residual Glomerular Filtration Rate in Dialysis Patients

Author: LiHui
Tutor: ZhongAiMin
School: Nanchang University
Course: Internal Medicine
Keywords: Cystatin C Hemodialysis Peritoneal Dialysis Residual renal function
CLC: R459.5
Type: Master's thesis
Year: 2009
Downloads: 85
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Abstract


Objective: To investigate the value of Cystatin C in the assessment dialysis patients with residual renal function (residual renal function, RRF) , looking for a dialysis patients compared with a simple, accurate RRF estimates indicators . Methods : 95 cases collected in our hospital dialysis patients ( hemodialysis patients 61 cases of peritoneal dialysis patients , 34 cases ), blood , urine specimens were measured serum creatinine (Scr) and urine creatinine (Ucr) and Serum Cystatin C concentration , collected between dialysis period of total urine output , creatinine clearance (Ccr) was measured as dialysis patients RRF. Analysis of Serum Cystatin C and RRF , and it is estimated the RRF (eGFR1) and based on Scr modified MDRD formula derivation the RRF (eGFR2), compared with the measured RRF . Results: hemodialysis (HD) group Cystatin C, measured RRF of Cystatin C eGFR1 , based on Scr of eGFR2 were 5.92 ± 0.75mg / L , 3.37 ± 0.99ml/min/1.73m2 , 2.83 ± 0.46 ml / min / 1.73m2, 6.20 ± 1.77 ml/min/1.73m2, peritoneal dialysis (PD) group were 5.79 ± 0.95 mg / L , 3.78 ± 1.01 , 3.35 ± 0.64 ml/min/1.73m2 ml/min/1.73m2 7.29 ± 1.28 ml / min / 1.73m2. All dialysis patients serum Cystatin C and Scr concentration accompanied by a reduction of RRF rise , but the Cystatin C 's rise smoothly than Scr . The HD group Cystatin C and Scr with RRF was a significant negative correlation (r = -0.53, P lt; 0.05 and r = -0.46 , P lt ; 0.05) , PD group had similar results (r = -0.71 , P lt ; 0.05 and r = -0.63, P lt ; 0.05) . HD group Cystatin C - based and Scr eGFR with RRF deviation , from 0.53 ± 0.77ml/min/1.73m2 and 2.83 ± 1.62ml/min/1.73m2, the PD group was 0.43 ± 0.72 ml/min/1.73m2 and 3.51 the ± 1.1ml/min/1.73m2, HD and PD groups were statistically significant ( P lt; 0.05 ) , respectively, based on the difference between Cystatin C the Scr eGFR1 and eGFR2 . Cystatin C and Scr measured of eGFR with RRF correlation coefficient in the HD group were 0.69 and 0.63 , the PD group 0.74 and 0.58 . Based Cystatin C and Scr the measured eGFR1 and eGFR2 HD group to strike a regression equation were eGFR1 = 1.83 0.30 × RRF (P lt; 0.05) , and eGFR2 = 3.50 0.85 x RRF ( P lt; 0.05 ) , the PD group : eGFR1 = 1.66 0.45 × RRF (P lt; 0.05) and eGFR2 = 4.64 0.70 × RRF (P lt; 0.05). Conclusion: Serum Cystatin C estimates dialysis patients RRF accurate , concise , Serum Cystatin C in the case of difficult to accurately collected 24 - hour urine specimens for dialysis patients with RRF estimates more than Scr .

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