Article

Prospective cohor study. Objectives:To investigate the relationship
between (51)chromium-ethylene-diamine-tetra-acetate ((51)Cr-EDTA) clearance,
serum cystatin C (CysC), serum creatinine, creatinine clearance and estimated
glomerular filtration rate (eGFR(MDRD), MDRD stands for modification of diet in
renal disease) based on the serum creatinine in patients with complete or
incomplete spinal cord injury (SCI) and to develop and evaluate a GFR-estimating
equation using serum CysC.Settings:Spinal Cord Injury Unit, Viborg Regional
Hospital, Viborg, Denmark.Methods:Ninety-eight men and 47 women with SCI were
included in the study. Serum CysC levels were measured by an automated
particle-enhanced nephelometric immunoassay, serum and urine creatinine levels
were measured by an enzymatic method traceable to the IDMS creatinine reference
method, and (51)Cr-EDTA clearance was measured by a multiple plasma sample
method.Results:The area under the curves (AUCs) in the non-parametric receiver
operating characteristics (ROC) plots for serum CysC were compared with serum
creatinine and to eGFR(MDRD) and revealed a significant difference (P-value<0.05)
for all SCI patients. There was no significant difference between the AUC for
serum CysC compared with the AUC for creatinine clearance. GFR (ml min(-1) per
1.73 m(2)) can be calculated from serum CysC values (mg l(-1)) using the equation
eGFR(CysC)=212.exp(0.914.CysC). The model accurately predicted the GFR of 88% of
patients within +/-30% of the measured GFR, and it was able to predict the GFR of
50% of patients within +/-10% of the measured GFR.Conclusion:In patients with
SCI, GFR can be estimated independent of age, sex and muscle mass by a newly
developed equation based on a single serum CysC value.

Langue : ANGLAIS