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Creatinine, urea nitrogen, cystatin C which can represent renal function?
Speaking of kidney function, kidney disease patient thinks first is oneself creatinine number. Also right, blood creatinine is a index in kidney function assay report, influence is greatest. But commonly besides creatinine, kidney function can measure a number of indicators. What is the most accurate indicator? Generally speaking, there are three main laboratory indicators of renal function:
Urea (nitrogen): urea nitrogen is elevated, often represent kidney function is not complete, now some textbooks still have the saying of nitrogen natremia. In fact, urea nitrogen reflects kidney function is very inaccurate, often suffer from diet, fever, infection. Heart failure, gastrointestinal bleeding and other factors.
Serum creatinine: because nephropathy experts found that urea nitrogen reflected the problem is not very reliable, found that the blood creatinine this index is more reliable, for decades have been using blood creatinine to reflect renal function. Since then, the blood creatinine appears to represent the kidney function.
In fact, blood creatinine detection also has its inherent deficiencies. Creatinine is the metabolite of creatine in muscle tissue, so creatinine will first be affected by human muscle content, the more developed muscle, the higher the muscle content. Blood creatinine is also naturally higher.
In addition, since the blood creatinine is affected by muscle metabolism, muscle metabolism will also affect the level of blood creatinine. Also, eating the meat of mammals in the stomach will also break down to produce creatinine. Biologically speaking. We are all mammals. At the top of the food chain, humans break down creatinine, even if it is exogenous creatinine, which to some extent leads to a rise in creatinine in the blood.
In addition, serum creatinine is also affected by age, sex, race and other factors. It is also affected by renal tubular excretion creatinine.
Therefore, the most important serum creatinine index is not perfect. Later, nephrologists developed a formula and equation based on blood creatinine to reflect renal function more accurately.
Serum cystatin C: it is not affected by sex, inflammation and muscle content, so cystatin C is a sensitive and accurate indicator of renal function.
It is regrettable that: Although in 2012, the guidelines for Clinical practice in the Evaluation and Management of chronic Kidney Disease (KDIGO) published to the world made several recommendations for the application of cystatin C in the definition and classification of chronic kidney disease in Chapter 1. But many clinicians, and even some renal doctors, are only looking at creatinine.
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