| Objectives To explore the performance differences of Chronic Kidney Diseases Epidemiology Collaboration(CKD-EPI)recommended three different CKD-EPI estimation formulas in evaluating renal function in elderly patients with hypertension,and to find suitable estimation methods for the convenient and accurate clinical evaluation of renal injury in elderly patients with hypertension.Methods Fifty-eight patients with essential hypertension aged(?65 years)hospitalized in the department of cardiology of our hospital from November 2018 to March 2019 were included in this study.Inclusion criteria: patients with abnormal results of any of the serum creatinine(Scr),blood urea nitrogen(BUN)and proteinuria were included in the hypertensive renal injury group(positive group,n=25),while those without abnormal results were included in the hypertensive group(negative group,n=33).Basic data including gender,age,height,weight,grade of hypertension,time of hypertension.The levels of Scr,BUN,serum uric acid(SUA),triglyceride(TG)and total cholesterol(TC)in fresh serum of the two groups were measured.The levels of Cystatin C(Cys C)were determined by enzyme-linked immunosorbent assay.According to CKD-EPI 2009 and CKD-EPI 2012 estimation formulas,respectively calculated the estimated glomerular filtration rate(e GFR),including e GFRScr,e GFRCys C and e GFRScr-Cys C?Results Between hypertensive renal injury group and simple hypertensive group,gender,age,grade of hypertension,BMI,TG,TC and time of hypertension,with no statistical significance between groups(P>0.05).The expression level of hypertensive renal injury group BUN[(7.06±2.17)mmol/l vs(4.86±1.09)mmol/l,P<0.001],SUA[(357.90±85.64)mmol/l vs(294.70±70.54)mmol/l,P=0.002],Scr[(88.15±19.14)umol/l vs(72.43±10.78)umol/l,P < 0.001],Cys C[(1.89±0.52)mg/l vs(1.58±0.23)mg/l,P=0.040] was significantly higher than the hypertension group(P<0.05).e GFRScr[(68.83±14.48)ml/(min·1.73m2)vs(77.63±10.13)ml/(min·1.73m2),P=0.009],e GFRCys C[32.00(23.00,42.00)ml/(min·1.73m2)vs 38.00(34.00,45.00)ml/(min·1.73m2),P=0.042],e GFRScr-Cys C [47.00(37.00,54.50)ml/(min·1.73m2)vs 53.00(49.00,59.00)ml/(min·1.73 m2),P=0.007] in hypertensive renal injury group were significantly lower than those in hypertension group,with statistically significant difference(P<0.05).By correlation analysis showed that Cys C was significantly correlated with e GFRScr(r=-0.369,P=0.004),e GFRCys C(r=-0.982,P < 0.001),e GFRScr-Cys C(r=-0.845,P < 0.001),Scr(r=0.427,P=0.001),SUA(r=0.266,P=0.044),BUN(r=0.357,P=0.006).There were no correlation with age,proteinuria,sex,BMI,TG,TC,grade of hypertension and time of hypertension.The comparison results of receiver operating characteristic(ROC)curve data of three estimation formulas show that: area under the curve(AUC)of CKD-EPIScr-Cys C is [0.707,95% CI(0.565,0.849)],Youden index(0.41),sensitivity(44.00%),specificity(97.00%).AUC of CKD-EPIScr is [0.683,95% CI(0.536,0.830)],Youden index(0.378),sensitivity(56.00%),specificity(81.80%).AUC of CKD-EPICys C was [0.657,95% CI(0.521, 0.777)],Youden index(0.48),sensitivity(48.00%),specificity(100%).Conclusions In the elderly patients with hypertensive renal function injury,the level of Cys C increased significantly.Among the three CKD-EPI estimation formulas,AUC of CKD-EPIScr-Cys C is the largest,and the diagnostic efficiency is relatively higher,indicating that CKD-EPIScr-Cys C has certainly diagnostic value of renal injury in elderly patients with hypertension.Figure 1;Table 6;Reference 112... |
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