血清标志物方程估算血液透析患者残肾功能及其临床应用价值

Clinical application of serum markers for estimation of residual kidney function in hemodialysis patients

目的探讨使用血清β-微量蛋白(β-TP)和β_2-微球蛋白(β2-M)预测方程估算血液透析(HD)患者的残肾功能,检出其残尿素清除率(KRU)值>2.00 ml/(min·1.73 m^2)的患者。方法用新KRU方程和尿常规方法估算42例HD的终末期肾病新患者残肾功能。结果 KRU常规方法测量值和方程估算值之间的中位数偏离为0.30 ml/(min·1.73 m^2)。用KRU估算值>2.00 ml/(min·1.73 m^2)作为截断值检出实测KRU值>2.00 ml/(min·1.73 m^2)患者的受者工作特征曲线(ROC)下面积为0.91,其敏感性为71%、特异性为96%。结论无需采集尿液,该方程即可检出KRU值>2.00 ml/(min·1.73 m^2)的HD患者。

Objective To investigate novel predictive equations based onβ-trac protein(β-TP)andβ2 Microglobulim(β2-M)for estimation of residual kidney function in hemodialysis(HD)patients.Methods Novel KRU equations and conventional method were performed in 42 HD patients with end-stage renal disease.Results Median bias of KRU between conventional method and novel equation was 0.30 ml/(min·1.73 m^2).With cut-off estimated KRU>2.00 ml/(min·1.73 m^2),area under receiving operator characteristic curve for identifying patient was 0.91;sensitivity was 71%and specificity was 96%.Conclusionsβ-TP andβ2-M based novel equation may be a promising tool to identify HD patients with KRU>2.00 ml/(min·1.73 m^2)without urine collection.