Serum Cystatin C Concentrations In Diabetic Nephropathy In The Assessment Of The Value Of Different Periods

BACKGROUD:Diabetic nephropathy in diabetic is the most common complications of disease, its early kidney damage is a very hidden pathological process. Slow progress, and no obvious clinical symptoms, the traditional marker for the evaluation of renal difficult to accurately judge. Diabetic patients with diabetic nephropathy is the leading cause of death in Western countries is the main reason for end-stage renal failure. It is reported that diabetic patients with non-diabetic patients 17 times, and with disease duration longer, the incidence of diabetic nephropathy increased, less than 5 years history of diabetes, diabetic nephropathy was 7% to 10%; history of diabetes were 10 to 20 years, diabetic nephropathy was 20% and 35%; diabetes mellitus more than 20 years, the incidence of diabetic nephropathy almost 100%. Diabetic nephropathy in diabetes mellitus if given early aggressive treatment, then still in the reversible stage renal disease, to improve the clinical symptoms of diabetes is significant, so the early diagnosis of diabetic nephropathy extremely important.OBJECTIVE:Patients with diabetic nephropathy due to longer life and improve their quality of life of the urgent need for early detection of diabetic nephropathy has important clinical value, the process of diabetic nephropathy and the relationship between cystatin C, and cystatin C, renal ball filtration rate, serum creatinine, creatinine clearance rate and the C-G equation estimates of glomerular filtration rate were compared.METHODS:The patients were in July 2009-January 2010 our hospital or clinic type 2 diabetic patients with nephropathy. A total of 82 cases. Type 2 diabetes mellitus (DM) are consistent with the diagnosis established by WHO in 1999, "the diagnosis and classification of diabetes standards." Reference Mogensen on diabetic nephropathy classification:Ⅰdiabetic nephropathy of the pre-diabetic period, with high filtration and characterized by renal enlargement, showed increased GFR;Ⅱdiabetic nephropathy of the recessive period after exercise may have urine albumin excretion rate of increased glomerular structural damage began to appear;Ⅲdiabetic nephropathy of the early period, urinary albumin excretion rate continued in the 20-200ug/min;ⅣDN of the clinical phase, UAER>20～200ug/min, or total urinary protein>0.5g/24h, glomerular filtration rate, renal function decline. The selected patients were divided into three groups, select theⅠ～Ⅱis a group of 28 patients; III as a group of 25 cases; IV is a group of 29 cases. Separate control group,20 cases for the healthy. All officers are excluded heart, brain, liver and kidney disease. All subjects were fasting after 8h blood sampling the next morning, immediately after collection submissionRESULTS:I group serum Cysc, Scr the concentrations were 1.75m±0.31mg/L, 66.25±13.20μmol/L. Compared to healthy control group, I group the concentration of serum Cysc, were significantly different (P<0.05); Scr the concentration was no significant difference (P>0.05). II group, the serum Cysc, Scr concentrations were 2.34±0.45 mg/L,114.97±17.67μmol/L.Ⅲgroup, the serum Cysc, Scr concentrations were 3.92±1.33 mg/L,185.59±18.13μmol/L.Ⅱ,Ⅲgroup serum Cysc, Scr levels were significantly higher compared to group I and significantly (P<0.05), see Table 1. The group in the isotopic method measured GFR and Ccr, C-G equation estimates of glomerular filtration rate was roughly the same, the difference was not statistically significant (P>0.05). AndⅡ,Ⅲin groupⅠcompared with GFR decline, the difference was statistically significant (P<0.05) See Table 2. Cysc negatively correlated with Ccr, and Scr, HbAl correlated. Were statistically significant (P<0.05), see Table 3.CONCLUSION:The serum level can be used as reaction Cysc early renal damage in diabetic nephropathy a good indicator for the impaired renal function, especially to provide early diagnosis. The results also show that with increasing degree of renal injury, Cysc showed an increasing trend. And with Ccr, Scr, HbAlc have a good correlation. Glomerular filtration rate can be estimated glomerular filtration rate.