当前位置：
X-MOL 学术
›
Clin. Interventions Aging
›
论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
The Association of Intraindividual Difference Between Cystatin- and Creatinine-Based Estimated GFR and Contrast-Associated Acute Kidney Injury
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2024-03-08 , DOI: 10.2147/cia.s447042 Li-Wei Zhang , Man-Qing Luo , Ji-Lang Zeng , Zhe-Bin You , Li-Chuan Chen , Jun-Han Chen , Kai-Yang Lin , Yan-Song Guo
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2024-03-08 , DOI: 10.2147/cia.s447042 Li-Wei Zhang , Man-Qing Luo , Ji-Lang Zeng , Zhe-Bin You , Li-Chuan Chen , Jun-Han Chen , Kai-Yang Lin , Yan-Song Guo
Purpose: The estimated glomerular filtration rate (eGFR) based on creatinine is crucial for the risk assessment of contrast-associated acute kidney injury (CA-AKI). In recent, the difference between cystatin C-based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcr) has been widely documented. We aimed to explore whether intraindividual differences between eGFRcys and eGFRcr had potential value for CA-AKI risk assessment in patients undergoing elective percutaneous coronary intervention (PCI).
Patients and Methods: From January 2012 to December 2018, we retrospectively observed 5049 patients receiving elective PCI. To determine eGFR, serum creatinine and cystatin C levels were measured. CA-AKI was defined as serum creatinine being increased ≥ 50% or 0.3 mg/dL within 48 h after contrast agents exposure. Chronic kidney disease (CKD) was defined as the eGFR < 60 mL/min/1.73 m2.
Results: Approximately half of the participants (2479, 49.1%) had a baseline eGFRdiff (eGFRcys-eGFRcr) between − 15 and 15 mL/min/1.73 m2. Restricted cubic splines analysis revealed a nonlinear relationship between eGFRdiff and CA-AKI. Multivariable logistic regression analysis indicated that compared with the reference group (− 15 to 15 mL/min/1.73 m2), the negative-eGFRdiff group (less than − 15 mL/min/1.73 m2) had a higher risk of CA-AKI (OR, 3.44; 95% CI, 2.57– 4.64). Furthermore, patients were divided into four groups based on CKD identified by eGFRcys or eGFRcr. Multivariable logistic analysis revealed that patients with either CKDcys (OR, 2.94; 95% CI, 2.19– 3.95, P < 0.001) or CKDcr (OR, 2.44; 95% CI, 1.19– 4.63, P < 0.001) had an elevated risk of CA-AKI compared to those without CKDcys and CKDcr.
Conclusion: There are frequent intraindividual differences between eGFRcys and eGFRcr, and these differences can be used to forecast the risk of CA-AKI.
Keywords: estimated glomerular filtration rate, contrast-associated acute kidney injury, cystatin C, percutaneous coronary intervention
中文翻译：
基于胱抑素和肌酐的估计 GFR 与对比相关急性肾损伤之间的个体差异的关联
目的：基于肌酐的估计肾小球滤过率 (eGFR) 对于对比剂相关急性肾损伤 (CA-AKI) 的风险评估至关重要。最近，基于胱抑素 C 的 eGFR (eGFRcys) 和基于肌酐的 eGFR (eGFRcr) 之间的差异已被广泛记录。我们的目的是探讨 eGFRcys 和 eGFRcr 之间的个体差异对于接受择期经皮冠状动脉介入治疗 (PCI) 的患者的 CA-AKI 风险评估是否具有潜在价值。
患者和方法：从2012年1月至2018年12月，我们回顾性观察了5049名接受择期PCI的患者。为了确定 eGFR，测量了血清肌酐和胱抑素 C 水平。CA-AKI定义为造影剂暴露后48小时内血清肌酐增加≥50%或0.3mg/dL。慢性肾病（CKD）定义为eGFR < 60 mL/min/1.73 m 2。
结果：大约一半的参与者（2479 名，49.1%）的基线 eGFRdiff (eGFRcys-eGFRcr) 介于 − 15 至 15 mL/min/1.73 m 2之间。受限三次样条分析揭示了 eGFRdiff 和 CA-AKI 之间的非线性关系。多变量logistic回归分析表明，与参考组（−15至15 mL/min/1.73 m 2）相比，负eGFRdiff组（小于− 15 mL/min/1.73 m 2）发生CA-的风险更高AKI（OR，3.44；95% CI，2.57-4.64）。此外，根据 eGFRcys 或 eGFRcr 识别的 CKD，将患者分为四组。多变量逻辑分析显示，患有 CKDcys（OR，2.94；95% CI，2.19-3.95，P < 0.001）或 CKDcr（OR，2.44；95% CI，1.19-4.63，P < 0.001）的患者发生以下疾病的风险较高： CA-AKI 与无 CKDcys 和 CKDcr 的患者相比。
结论： eGFRcys和eGFRcr之间存在频繁的个体差异，这些差异可以用来预测CA-AKI的风险。
关键词：估计肾小球滤过率，造影剂相关急性肾损伤，胱抑素C，经皮冠状动脉介入治疗
更新日期：2024-03-07
Patients and Methods: From January 2012 to December 2018, we retrospectively observed 5049 patients receiving elective PCI. To determine eGFR, serum creatinine and cystatin C levels were measured. CA-AKI was defined as serum creatinine being increased ≥ 50% or 0.3 mg/dL within 48 h after contrast agents exposure. Chronic kidney disease (CKD) was defined as the eGFR < 60 mL/min/1.73 m2.
Results: Approximately half of the participants (2479, 49.1%) had a baseline eGFRdiff (eGFRcys-eGFRcr) between − 15 and 15 mL/min/1.73 m2. Restricted cubic splines analysis revealed a nonlinear relationship between eGFRdiff and CA-AKI. Multivariable logistic regression analysis indicated that compared with the reference group (− 15 to 15 mL/min/1.73 m2), the negative-eGFRdiff group (less than − 15 mL/min/1.73 m2) had a higher risk of CA-AKI (OR, 3.44; 95% CI, 2.57– 4.64). Furthermore, patients were divided into four groups based on CKD identified by eGFRcys or eGFRcr. Multivariable logistic analysis revealed that patients with either CKDcys (OR, 2.94; 95% CI, 2.19– 3.95, P < 0.001) or CKDcr (OR, 2.44; 95% CI, 1.19– 4.63, P < 0.001) had an elevated risk of CA-AKI compared to those without CKDcys and CKDcr.
Conclusion: There are frequent intraindividual differences between eGFRcys and eGFRcr, and these differences can be used to forecast the risk of CA-AKI.
Keywords: estimated glomerular filtration rate, contrast-associated acute kidney injury, cystatin C, percutaneous coronary intervention
中文翻译：
基于胱抑素和肌酐的估计 GFR 与对比相关急性肾损伤之间的个体差异的关联
目的：基于肌酐的估计肾小球滤过率 (eGFR) 对于对比剂相关急性肾损伤 (CA-AKI) 的风险评估至关重要。最近，基于胱抑素 C 的 eGFR (eGFRcys) 和基于肌酐的 eGFR (eGFRcr) 之间的差异已被广泛记录。我们的目的是探讨 eGFRcys 和 eGFRcr 之间的个体差异对于接受择期经皮冠状动脉介入治疗 (PCI) 的患者的 CA-AKI 风险评估是否具有潜在价值。
患者和方法：从2012年1月至2018年12月，我们回顾性观察了5049名接受择期PCI的患者。为了确定 eGFR，测量了血清肌酐和胱抑素 C 水平。CA-AKI定义为造影剂暴露后48小时内血清肌酐增加≥50%或0.3mg/dL。慢性肾病（CKD）定义为eGFR < 60 mL/min/1.73 m 2。
结果：大约一半的参与者（2479 名，49.1%）的基线 eGFRdiff (eGFRcys-eGFRcr) 介于 − 15 至 15 mL/min/1.73 m 2之间。受限三次样条分析揭示了 eGFRdiff 和 CA-AKI 之间的非线性关系。多变量logistic回归分析表明，与参考组（−15至15 mL/min/1.73 m 2）相比，负eGFRdiff组（小于− 15 mL/min/1.73 m 2）发生CA-的风险更高AKI（OR，3.44；95% CI，2.57-4.64）。此外，根据 eGFRcys 或 eGFRcr 识别的 CKD，将患者分为四组。多变量逻辑分析显示，患有 CKDcys（OR，2.94；95% CI，2.19-3.95，P < 0.001）或 CKDcr（OR，2.44；95% CI，1.19-4.63，P < 0.001）的患者发生以下疾病的风险较高： CA-AKI 与无 CKDcys 和 CKDcr 的患者相比。
结论： eGFRcys和eGFRcr之间存在频繁的个体差异，这些差异可以用来预测CA-AKI的风险。
关键词：估计肾小球滤过率，造影剂相关急性肾损伤，胱抑素C，经皮冠状动脉介入治疗
京公网安备 11010802027423号