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Cystatin C-Based eGFR Strongly Correlates With Creatinine-Based eGFR

More than one in four patients reclassified as having more severe chronic kidney stage based on cystatin C results

By Lori Solomon HealthDay Reporter

MONDAY, March 6, 2023 (HealthDay News) — Cystatin C estimation of glomerular filtration rate (eGFR) correlates strongly with creatinine eGFR but can have a substantial effect on chronic kidney disease (CKD) staging, according to a study published in the March issue of Kidney Medicine.

Eric Raphael Gottlieb, M.D., from Mount Auburn Hospital in Cambridge, Massachusetts, and colleagues examined how cystatin C correlates with creatinine eGFR and how it indicates differences in CKD staging. The analysis included 1,783 inpatients and outpatients who had cystatin C and creatinine levels drawn within 24 hours.

The researchers found that cystatin C-based eGFR was very strongly correlated with creatinine-based eGFR (Spearman correlation ρ = 0.83). Cystatin C eGFR resulted in no change to CKD stage for two-thirds of patients but resulted in a change to a later CKD stage in 27 percent and an earlier stage in 7 percent. There was a lower likelihood of change to a later stage for Black patients (odds ratio, 0.53), while age (odds ratio per year, 1.03) and Elixhauser score (odds ratio per point, 1.22) were associated with a higher likelihood of change to a later stage.

“This study demonstrates the importance of a broad campaign to educate clinicians and develop guidelines regarding the application of cystatin C eGFR and to mitigate the confusion that differences between creatinine eGFRs may raise,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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