老年人肾功能评估现状与进展

Kidney function evaluation for the elderly: current status and progress

摘要:

老年人慢性肾脏病（CKD）的患病人数增长迅猛，准确、灵敏地筛查出该类患者具有重要的意义。常用的肾功能指标中，目前较为认可的是血清肌酐（SCr）和血清胱抑素（Cys C）。在筛查我国老年CKD患者时，Cys C可能更加灵敏和特异。肾小球滤过率（GFR）估算公式的评估价值可能优于肾功能单指标。公式的准确性似乎并不与原发病或基础病有关，而与种族、年龄等因素有关，更与公式的设计开发时的准确性密切相关。以我国老年人群为研究对象，进行多中心，大样本，统一实验室方法的合作，开发全新的GFR公式，显得十分迫切和重要。对于老年人群，CKD的定义及分期可能还需要特殊的界定，以便更准确地区分出CKD患者。

Abstract:

With the quick expanding of chronic kidney disease (CKD) in the elderly patients, it is of great significance to accurately and sensitively screen the vulnerable population. As the common kidney function markers, serum creatinine (SCr) and serum cystatin C have been publicly approved. But when applied in the elderly, cystatin C may be superior to SCr, and the equations for estimated glomerular filtration rate (GFR) are more accurate than the former two biomarkers. The accuracy of equations seems unrelated to the primary disease, but closely related to race, age and the development design of the equations. To develop a brand new GFR equation with large samples in multi-centers and uniform determination standard from different laboratories is of great urgency and importance. In addition, a special definition and classification of the elderly CKD patients could be conducive to distinguish the real ones.