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

摘要:

目的 探讨使用血清β- 微量蛋白（β-TP）和β2- 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 m2）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 m2）。用KRU 估算值>2.00 ml/（min·1.73 m2）作为截断值检出实测 KRU 值>2.00 ml/（min·1.73 m2）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 m2）的HD 患者。

Abstract:

Objective To investigate novel predictive equations based on β-trac protein (β-TP) and β2 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 m2). With cut-off estimated KRU > 2.00 ml/(min·1.73 m2), area under receiving operator characteristic curve for identifying patient was 0.91; sensitivity was 71% and specificity was 96%. Conclusions β-TP and β2-M based novel equation may be a promising tool to identify HD patients with KRU > 2.00 ml/(min·1.73 m2) without urine collection.