The development of formulas estimating glomerular filtration rate(eG FR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity...The development of formulas estimating glomerular filtration rate(eG FR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease(CKD),which is based on e GFR values and albuminuria.This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course. Disagreements between creatinine-based and cystatin-based e GFR values and between e GFR values and measured GFR have been reported in various cohorts. These disagreements are the consequence of variations in the rate of production and in factors, other than GFR, affecting the rate of removal of creatinine and cystatin C. The disagreements create limitations for all e GFR formulas developed so far. The main limitations are low sensitivity in detecting early CKD in several subjects, e.g., those with hyperfiltration, and poor prediction of the course of CKD. Research efforts in CKD are currently directed towards identification of biomarkers that are better indices of GFR than the current biomarkers and,particularly, biomarkers of early renal tissue injury.展开更多
AIM:To compare creatinine clearance(Ccr) with estimated glomerular filtration rate(eGFR) in preoperative renal function tests in patients undergoing hepatectomy.METHODS:The records of 197 patients undergoing hepatecto...AIM:To compare creatinine clearance(Ccr) with estimated glomerular filtration rate(eGFR) in preoperative renal function tests in patients undergoing hepatectomy.METHODS:The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied,and preoperative Ccr,a three-variable equation for eGFR(eGFR3) and a five-variable equation for eGFR(eGFR5) were calculated.Abnormal values were defined as Ccr < 50 mL/min,eGFR3 and eGFR5 < 60 mL/min per 1.73 m2.The maximum increases in the postoperative serum creatinine(post Cr) level and postoperative rate of increase in the serum Cr level(post Cr rate) were compared.RESULTS:There were 37 patients(18.8%) with abnormal Ccr,31(15.7%) with abnormal eGFR3,and 40(20.3%) with abnormal eGFR5.Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr,eGFR3 and eGFR5 values,the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients(P < 0.0001).Post Cr level tended to be higher in patients with Ccr abnormality(P = 0.0936 and P = 0.0875,respectively).CONCLUSION:eGFR5 and the simpler eGFR3,rather than Ccr,are recommended as a preoperative renal function test in patients undergoing hepatectomy.展开更多
目的探讨益气养阴通络方联合羟苯磺酸钙对糖尿病肾病(气阴两虚血瘀证)疗效的影响。方法选取120例糖尿病肾病(气阴两虚血瘀证)患者为研究对象,随机分为对照组(60例)和观察组(60例),其中对照组给予羟苯磺酸钙治疗,观察组给予益气养阴通络...目的探讨益气养阴通络方联合羟苯磺酸钙对糖尿病肾病(气阴两虚血瘀证)疗效的影响。方法选取120例糖尿病肾病(气阴两虚血瘀证)患者为研究对象,随机分为对照组(60例)和观察组(60例),其中对照组给予羟苯磺酸钙治疗,观察组给予益气养阴通络方联合羟苯磺酸钙治疗。比较2组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2 h PGB)水平;利用自动生化分析仪检测治疗前后总胆固醇(TC)、甘油三酯(TG)水平;采用免疫比浊法测定血尿素氮(BUN)和血清肌酐(Scr)水平;采集患者治疗前后24 h尿液,利用苦味酸法检测24 h尿蛋白定量(24 h Upro)水平;采用酶联免疫吸附试剂盒检测血清血管内皮生长因子(VEGF)、内皮素(ET-1)及一氧化氮(NO)水平。结果观察组治疗总有效率为91.67%,高于对照组的70.00%,差异有统计学意义(P<0.05)。2组治疗后FBG、2 h PGB、TC、TG水平较治疗前下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05)。2组治疗后BUN、Scr及24 h Upro水平较治疗前均下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05);2组治疗后肌酐清除率(Ccr)水平相较于治疗升高,且观察组升高幅度大于对照组,差异有统计学意义(P<0.05)。2组治疗后血液流变学指标水平较治疗前均下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05)。2组治疗后ET-1水平较治疗前下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05);2组治疗后VEGF、NO水平较治疗前升高,且观察组升高幅度大于对照组,差异有统计学意义(P<0.05)。结论益气养阴通络方联合羟苯磺酸钙治疗糖尿病肾病可有效调节糖脂代谢,改善肾功能、血液流变学指标水平及血管内皮功能。展开更多
基金the Research Service of the Raymond G. Murphy VA Medical Center for its support of this work
文摘The development of formulas estimating glomerular filtration rate(eG FR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease(CKD),which is based on e GFR values and albuminuria.This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course. Disagreements between creatinine-based and cystatin-based e GFR values and between e GFR values and measured GFR have been reported in various cohorts. These disagreements are the consequence of variations in the rate of production and in factors, other than GFR, affecting the rate of removal of creatinine and cystatin C. The disagreements create limitations for all e GFR formulas developed so far. The main limitations are low sensitivity in detecting early CKD in several subjects, e.g., those with hyperfiltration, and poor prediction of the course of CKD. Research efforts in CKD are currently directed towards identification of biomarkers that are better indices of GFR than the current biomarkers and,particularly, biomarkers of early renal tissue injury.
文摘AIM:To compare creatinine clearance(Ccr) with estimated glomerular filtration rate(eGFR) in preoperative renal function tests in patients undergoing hepatectomy.METHODS:The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied,and preoperative Ccr,a three-variable equation for eGFR(eGFR3) and a five-variable equation for eGFR(eGFR5) were calculated.Abnormal values were defined as Ccr < 50 mL/min,eGFR3 and eGFR5 < 60 mL/min per 1.73 m2.The maximum increases in the postoperative serum creatinine(post Cr) level and postoperative rate of increase in the serum Cr level(post Cr rate) were compared.RESULTS:There were 37 patients(18.8%) with abnormal Ccr,31(15.7%) with abnormal eGFR3,and 40(20.3%) with abnormal eGFR5.Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr,eGFR3 and eGFR5 values,the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients(P < 0.0001).Post Cr level tended to be higher in patients with Ccr abnormality(P = 0.0936 and P = 0.0875,respectively).CONCLUSION:eGFR5 and the simpler eGFR3,rather than Ccr,are recommended as a preoperative renal function test in patients undergoing hepatectomy.
文摘目的探讨益气养阴通络方联合羟苯磺酸钙对糖尿病肾病(气阴两虚血瘀证)疗效的影响。方法选取120例糖尿病肾病(气阴两虚血瘀证)患者为研究对象,随机分为对照组(60例)和观察组(60例),其中对照组给予羟苯磺酸钙治疗,观察组给予益气养阴通络方联合羟苯磺酸钙治疗。比较2组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2 h PGB)水平;利用自动生化分析仪检测治疗前后总胆固醇(TC)、甘油三酯(TG)水平;采用免疫比浊法测定血尿素氮(BUN)和血清肌酐(Scr)水平;采集患者治疗前后24 h尿液,利用苦味酸法检测24 h尿蛋白定量(24 h Upro)水平;采用酶联免疫吸附试剂盒检测血清血管内皮生长因子(VEGF)、内皮素(ET-1)及一氧化氮(NO)水平。结果观察组治疗总有效率为91.67%,高于对照组的70.00%,差异有统计学意义(P<0.05)。2组治疗后FBG、2 h PGB、TC、TG水平较治疗前下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05)。2组治疗后BUN、Scr及24 h Upro水平较治疗前均下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05);2组治疗后肌酐清除率(Ccr)水平相较于治疗升高,且观察组升高幅度大于对照组,差异有统计学意义(P<0.05)。2组治疗后血液流变学指标水平较治疗前均下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05)。2组治疗后ET-1水平较治疗前下降,且观察组下降幅度大于对照组,差异有统计学意义(P<0.05);2组治疗后VEGF、NO水平较治疗前升高,且观察组升高幅度大于对照组,差异有统计学意义(P<0.05)。结论益气养阴通络方联合羟苯磺酸钙治疗糖尿病肾病可有效调节糖脂代谢,改善肾功能、血液流变学指标水平及血管内皮功能。
