Cystatin C was introduced as a potential alternative or supplement to the estimation of glomerular filtration rate (GFR) using creatinine. Although cystatin C is well supported as a better predictor of outcomes than creatinine, its reflection of actual renal function compared with creatinine is widely debated. A new study by Rule et al. asserts that cystatin-C-based estimated GFR is biased by non-GFR-associated risk factors for chronic kidney disease.
Key Points
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Creatinine-based estimated glomerular filtration rate (eGFR) is known to be biased by creatinine production in muscle
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Cystatin-C-based eGFR is biased by numerous chronic kidney disease (CKD)-associated risk factors, including BMI, hypertension and C-reactive protein level
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Although cystatin C is a better predictor of outcomes than is creatinine, it may reflect CKD risk factors and caution is therefore needed in interpreting it as true renal function
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Jablonski, K., Chonchol, M. Cystatin-C-based eGFR: what is it telling us?. Nat Rev Nephrol 9, 318–319 (2013). https://doi.org/10.1038/nrneph.2013.77
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DOI: https://doi.org/10.1038/nrneph.2013.77
