ABSTRACT
Objective:Explored the clinical application value of the current reference interval of serum creatinine (using the 2015 health industry standard) and the original reference interval (using the third edition of the clinical laboratory operating procedures).Methods:This paper is a retrospective study. The study collected 360 normal serum samples of the adults who visited the First Hospital of Hebei Medical University from February to April 2019 and,aged 20-79 years old (including 90 males aged 20-59, 90 females aged 20-59, 90 males aged 60-79, and 90 females aged 60-79). The concentration of cystatin C was determined in the above specimens, combined with the concentration of creatinine, and the results calculated by the Glomerular Filtration Rate Estimation Formula (eGFR) was used as the standard for judgment. In this study, the chi-square test was used to statistically analyze the agreement between the results of the new and old reference intervals of creatinine and the results calculated by the eGFR formula.Results:The total coincidence rate of Scr and eGFR in 360 adults aged 20-79 years was 83.40% in the current RI, and 77.00% in the original RI. The coincidence rate of the former was significantly higher than that of the latter ( P=0.03). The positive coincidence rate of Scr and eGFR (214 patients with eGFR positive) was 91.86% in current RI, 41.59% in the original RI, the coincidence rate of the former was significantly higher than that of the latter ( P<0.01). The negative coincidence rate of Scr and eGFR (146 patients with eGFR negative) was 74.66% in current RI, and 99.32% in original RI, the coincidence rate of the latter was significantly higher than that of the former ( P<0.01). Consistent results were shown in groups of males aged 20-59, females aged 20-59 and females aged 60-79. However, in the group of males aged 60-79 years, the total coincidence rate of Scr and eGFR was 75.56% in current RI, and 88.89% in original RI, the coincidence rate of the latter was significantly higher than that of the former ( P =0.01); positive coincidence rate of Scr and eGFR was 57.69% in current RI, and 98.08% in original RI, the coincidence rate of the latter was significantly higher than that of the former ( P<0.01); negative coincidence rate of Scr and eGFR was 100.0% in current RI, and 76.32% in original RI, the coincidence rate of the former was significantly higher than that of the latter ( P<0.01). Conclusions:The current reference interval is better than the original reference interval in screening for decreased glomerular filtration rate, and it is favorable for the early detection of patients with mildly decreased renal function. However, among males aged 60-79 years old, the accuracy of the current RI and the ability to screen for decreased glomerular filtration rate are inferior to the original RI, which needs to be further observed and studied.
ABSTRACT
Objective To investigate the change of urinary podocalyxin(PCX) and vascular endothelial growth factor (VEGF) levels and its association with the oxidative stress in the patients with type 2 diabetes mellitus(T2DM ) complicating dif‐ferent degrees of diabetic nephropathy .Methods Totally 186 patients with T2DM were divided into the pure T2DM (SDM ,62 ca‐ses) ,trace amount group(NA group ,60 cases) and massive amount group(MA group ,64 cases) according to the 24 h urinary albu‐min excretion rate(UAER) .60 cases of normal 24 h UAER were taken as the control group(NC group) .The levels of PCX ,VEGF , superoxide dismutase (SOD) ,malondialdehyde(MDA) and glutathione peroxidase (GSH‐px)were determined .Results Compared with other three groups ,the level of VEGF ,PCX and MDA in the MA group were highest(P<0 .01) ,while the levels of SOD and GSH‐px were lowest(P<0 .01 ,P<0 .05) .VEGF ,UAER ,HbA1c were the independent risk factors for urinary PCX .Conclusion In patients with diabetic nephropathy ,urinary PCX and VEGF are correlated with the oxidative stress ,while the oxidative stress is closely correlated with glomerular podocyte injury .