RESUMO
BACKGROUND: In our clinical experience, cystatin C (CysC) concentrations are not as high as expected in patients with chronic kidney disease (CKD) and high-stage renal dysfunction. We therefore investigated whether measurements of serum CysC result in an underestimation of renal dysfunction in pediatric patients with CKD. METHODS: Glomerular filtration rate (GFR) was estimated from serum creatinine (Cr) concentration, using the equation Cr-GFR (%) = [0.30 × body length (m)/serum Cr] × 100; and from serum CysC concentration, using the equation Cys-GFR (%) = (0.70/serum CysC) × 100. We investigated the relationship between GFR estimated by these 2 equations. Patients aged 2-12 years were assorted into 5 groups, based on GFR-Cr categories of <12.5, ≥12.5 to <25, ≥25 to <50, ≥50 to <75, and ≥75%, and GFR-CysC/GFR-Cr ratios were compared in these 5 groups. RESULTS: The median GFR-CysC/GFR-Cr ratio in groups of patients with GFR-Cr of <12.5, ≥12.5 to <25, ≥25 to <50, ≥50 to <75, and ≥75% were 2.28, 1.48, 1.22, 1.18 and 0.98, respectively, with statistically significant differences between any two groups (p < 0.001). CONCLUSION: Measurements of serum CysC concentrations lead to underestimation of renal dysfunction in pediatric patients with CKD.
Assuntos
Cistatina C/sangue , Falência Renal Crônica/sangue , Insuficiência Renal Crônica/sangue , Criança , Pré-Escolar , Creatinina/sangue , Reações Falso-Negativas , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/fisiopatologia , Falência Renal Crônica/fisiopatologia , Masculino , Conceitos Matemáticos , Insuficiência Renal Crônica/fisiopatologiaRESUMO
BACKGROUND: Single measurements of serum cystatin C (cysC) concentration have generally been used to determine glomerular filtration rate (GFR) in adults. Since GFR varies to some extent among children, we attempted to determine reference serum cysC concentrations for Japanese children. METHODS: Serum cysC concentrations were determined by a latex particle-enhanced turbidimetric immunoassay in children who did not present with kidney disease or infectious disease, and the relationship between age and serum cysC level was assessed. RESULTS: We found that reference serum cysC levels gradually decreased during the first year after birth, thereafter becoming constant. Mean serum cysC concentration in children aged 1 year (0.76 ± 0.10 mg/L) was slightly higher than in children aged ≥2 years (0.70 ± 0.09 mg/L). CONCLUSION: Our reference values will be applicable for screening renal function in Japanese children.
Assuntos
Cistatina C/sangue , Testes de Função Renal , Adolescente , Envelhecimento/sangue , Povo Asiático , Criança , Pré-Escolar , Feminino , Taxa de Filtração Glomerular , Humanos , Lactente , Recém-Nascido , Testes de Função Renal/métodos , Testes de Função Renal/normas , Masculino , Nefelometria e Turbidimetria/normas , Valores de ReferênciaRESUMO
BACKGROUND: Epidemiologic studies have shown the association between alcohol consumption and colorectal cancer, especially for rectal cancer. The alcohol related enzyme encoding gene ALDH2 has polymorphism Glu487Lys, and 487Lys allele is closely linked with phenotypic loss of enzyme activity. MATERIALS AND METHODS: A hospital-based case-control study was conducted with 72 colon and 70 rectal cancer cases and 241 non-cancer controls to evaluate the alcohol consumption and ALDH2 Glu487Lys polymorphism. The logistic regression model was applied to estimate the odds ratios (ORs). RESULT: The crude ORs for Glu/Lys and Lys/Lys genotype relative to Glu/Glu for colon and rectal cancer were not statistically significant. However, with the rectal cancer analysis, the ORs for high alcohol consumption were greater with 487Glu/Lys genotype compared with Glu/Glu, albeit not. CONCLUSIONS: These observations suggested rectal cancer risk might be influenced by ALDH2 gene polymorphism. The prevention effect by alcohol reduction might differ by ALDH2 genotype.