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Báo cáo khoa học: "Cystatin C: unsuited to use as a marker of kidney function in the intensive care unit"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Cystatin C: unsuited to use as a marker of kidney function in the intensive care unit. | Available online http ccforum.eom content 9 5 531 Letter Cystatin C unsuited to use as a marker of kidney function in the intensive care unit Raymond Wulkan1 Jan den Hollander2 and Arie Berghout2 Clinical Biochemist Department of Clinical Chemistry Hospital MCRZ Rotterdam The Netherlands 2Consultant Physician Department of Internal Medicine Hospital MCRZ Rotterdam The Netherlands Corresponding author Raymond Wulkan WulkanR@mcrz.nl Published online 10 May 2005 This article is online at http ccforum.com content 9 5 531 2005 BioMed Central Ltd Critical Care 2005 9 531-532 DOI 10.1186 cc3541 See related research by Villa et al. issue 9.2 http ccforum.com content 9 2 R139 We read with interest the article by Villa and coworkers 1 advocating the use of cystatin C as a measure of glomerular filtration rate GFR in critically ill patients. However we should like to draw attention to several flaws in this study. First Villa and coworkers compared cystatin C with creatinine as a measure of GFR using body surface corrected creatinine clearance as what they call a gold standard . However in the Discussion section of that report inulin and iothalamate clearances are mentioned as gold standards but they were not used by these investigators. The use of body surface area corrected creatinine clearance is questionable in both obese and excessively lean individuals because the correlation between surface area and lean body mass may be lost. Both types of patients are frequently encountered in intensive care. Second Villa and coworkers employ a cutoff of 80 ml min to identify renal dysfunction whereas a value of 50 ml min is generally accepted 2 . This could have a major influence on the presented results. Third patients with thyroid disorders or on corticosteroid therapy were excluded. Almost all patients with critical illness have low tri-iodothyronine values because of changes in thyroid hormone metabolism nonthyroidal illness thus making recognition of thyroid disorders .