CAJ | 학술논문

慢性肾脏病患者肾功能下降程度与其死亡、心血管事件和进展至终末期肾脏病的风险密切相关，目前临床常用基于血肌酐或胱抑素C的肾小球滤过率估算方程对肾功能进行评估。虽然不断改进基于肌酐的GFR评估公式可以更准确地评估肾功能，但肌酐在估算GFR方面存在的先天缺陷是难以克服的。大量研究发现，以胱抑素C为基础的肾小球滤过率估算方程相对于以血肌酐为基础的肾小球滤过率估算方程在评估慢性肾脏病预后方面具有显著差异，前者特异性更好，可以减少对于低危患者的不必要的肾科就诊和检查，又可以使高危患者得到更准确地辨认从而及时就诊干预。本文着重介绍肌酐和胱抑素C在慢性肾脏病诊断及预后风险评估方面的差异。（中华检验医学杂志，2014，37：415-419）
만성신장병환자신공능하강정도여기사망、심혈관사건화진전지종말기신장병적풍험밀절상관，목전림상상용기우혈기항혹광억소C적신소구려과솔고산방정대신공능진행평고。수연불단개진기우기항적GFR평고공식가이경준학지평고신공능，단기항재고산GFR방면존재적선천결함시난이극복적。대량연구발현，이광억소C위기출적신소구려과솔고산방정상대우이혈기항위기출적신소구려과솔고산방정재평고만성신장병예후방면구유현저차이，전자특이성경호，가이감소대우저위환자적불필요적신과취진화검사，우가이사고위환자득도경준학지변인종이급시취진간예。본문착중개소기항화광억소C재만성신장병진단급예후풍험평고방면적차이。（중화검험의학잡지，2014，37：415-419）
Renal function is closely associated with the risk of mortality ,cardiovascular events ,and progression to end stage of renal disease for patients with chronic kidney disease ( CKD ).Equations for estimated glomerular filtration rate ( GFR) based on serum creatinine or Cystatin C are frequently used in clinical evaluation of renal function.Although renal function can be more accurately assessed due to improvement in equations for estimated GFR ,it is difficult to overcome the inherent defect of creatinine based GFR estimation.Abundant ,evidence showed that Cystatin C based GFR estimation presented higher accuracy of prognosis assessment in CKD patients than creatinine based GFR estimation ,thus reduce the unnecessary nephrologist referral and measurements for low risk patients ,and also guarantee the timely recognization and intervention for high risk patients.This article deeply reviewed the role of serum creatinine or Cystatin C played in CKD diagnosis and prognosis assessment.