More Evidence that Cystatin C Predicts Mortality Better than Creatinine

[摘要] The main clinical benefit of estimating renal function in the general population is to identify and treat patients at risk for developing ESRD, cardiovascular events, and death.1 Unfortunately, the most widely used equations to estimate GFR are limited, in part, by their reliance on serum creatinine as the filtration marker (estimated GFR [eGFR]). The Modification of Diet in Renal Disease (MDRD) equation, for example, overestimates renal function among individuals with low muscle mass and underestimates it among those with GFR >60 ml/min per 1.73 m2.2–4 The use of serum cystatin C, a cysteine protease inhibitor that is freely filtered by the glomerulus, has potential advantages over creatinine as a filtration marker in that its production is not dependent on muscle mass.2 As a result, cystatin C offers opportunities to estimate GFR more accurately than creatinine-based equations and additionally may predict worsening kidney function even when the GFR is actually near the normal range.5

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome