Comparison of diagnostic value in early diabetic nephropathy among three kinds of glomerular nitration rate estimation equations
10.3760/cma.j.issn.1001-7097.2011.05.009
- VernacularTitle:三种肾小球滤过率评估方程对早期糖尿病肾病的诊断价值比较
- Author:
Hongxia ZHANG
;
Jie YUAN
;
Jie LIU
;
Weiping JIA
- Publication Type:Journal Article
- Keywords:
Diabetes;
Diabetic nephropathy;
Creatinine;
Cystatin C
- From:
Chinese Journal of Nephrology
2011;27(5):341-345
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of CysC-based CFR in comparison with creatinine-based GFR (CG-GFR and MDRD-GFR) as an accurate serum marker in the prediction of early diabetic nephropathy. Methods A tatal of 133 type 2 diabetic patients (74 males and 59 females, aged 58.1 ±12.3) were enrolled. The level of diabetic nephropathy (normoalbuminuric, microalbuminuric and macroalbuminuric) was staged and estimated GFR based on serum creatinine and cystatin C(CysC) was calculated. The plasma clearance of Tc-DTPA, serum CysC, creatinine, BMI, HbA1c, serum lipid and blood pressure were measured. Results 99mTc-DTPA-GFR was used as golden standard. At 90 and 75 ml· min-1· (1.73 m2)-1 cut-points, diagnostic efficiencies of CysC-GFR (89% and 92%) were better than those of CG-GFR (79%=86%, P=0.004, 0.04) and MDRD-GFR (80%-86%, P=0.02, 0.04). At 60 ml · min-1 · (1.73 m2)-1 cut-point, diagnostic efficiencies of CysC-GFR,CG-GFR and MDRD-GFR were 92%, 90% and 92% respectively (P= 0.49, P=0.71). The Logistic regression analyses showed that retinopathy, HbA1c, CysC, diabetic duration, and CysC-GFR were indicators to predict the development of microalbuminuria. Conclusion CysC-GFR is more valuable than CG-GFR and MDRD-GFR in the prediction of early diabetic nephropathy and should be applied clinically.
