期刊
CLINICAL BIOCHEMISTRY
卷 40, 期 5-6, 页码 383-391出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.clinbiochem.2006.10.026
关键词
cystatin C; serum creatinine; glomerular filtration rate; diagnostics odds ratio; kidney function
Objectives: To perform a systematic review comparing the diagnostic accuracy of CysC with SCr. Methods: MEDLINE and EMBASE (January 1984-February 2006) were searched. Studies included i) evaluated CysC against a recognised 'gold standard' method for determining GFR using a receiver operating characteristics (ROC) curve analysis and ii) included data that could be extracted into a 2 x 2 table. Results: The search identified 27 population groups in 24 studies (n=2007) that compared the diagnostic accuracy of CysC with SCr. The diagnostic odds ratios (DORs) (95% CI) of predicting renal dysfunction derived from a Moses-Littenberg linear regression model were 3.99 (3.41-4.57) for CysC and 2.79 (2.12-3.46) for SCr. Conclusion: The diagnostic accuracy for impaired renal function favours CysC. However, the confidence intervals for the pooled DORs for the biomarkers overlap. The ability of CysC (cut-off values between 0.9 and 1.4 mg/L) to rule in renal impairment (as measured by inulin-determined GFR of 60-79 mL/min/1.73 m(2)) in persons in whom this is suspected is large and conclusive. (c) 2007 Published by The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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