Advantages, Limitations, and Clinical Considerations in Using Cystatin C to Estimate GFR

Cystatin C has been shown to be a reliable and accurate marker of kidney function across diverse populations. The 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommended using cystatin C to confirm the diagnosis of chronic kidney disease (CKD) determined by creatinine-based esti...

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Bibliographic Details
Published in:Kidney360 Vol. 3; no. 10; pp. 1807 - 1814
Main Authors: Chen, Debbie C., Potok, O. Alison, Rifkin, Dena, Estrella, Michelle M.
Format: Journal Article
Language:English
Published: United States American Society of Nephrology 27.10.2022
Subjects:
Creatinine
Cystatin C
Glomerular Filtration Rate
Humans
Kidney Function Tests
Renal Insufficiency, Chronic - diagnosis
Review
eGFR
cystatin C
clinical nephrology
ISSN:2641-7650, 2641-7650
Online Access:Get full text
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Summary:Cystatin C has been shown to be a reliable and accurate marker of kidney function across diverse populations. The 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommended using cystatin C to confirm the diagnosis of chronic kidney disease (CKD) determined by creatinine-based estimated glomerular filtration rate (eGFR) and to estimate kidney function when accurate eGFR estimates are needed for clinical decision-making. In the efforts to remove race from eGFR calculations in the United States, the National Kidney Foundation (NKF) and American Society of Nephrology (ASN) Joint Task Force recommended increasing availability and clinical adoption of cystatin C to assess kidney function. This review summarizes the key advantages and limitations of cystatin C use in clinical practice. Our goals were to review and discuss the literature on cystatin C; understand the evidence behind the recommendations for its use as a marker of kidney function to diagnose CKD and risk stratify patients for adverse outcomes; discuss the challenges of its use in clinical practice; and guide clinicians on its interpretation.
Bibliography:Correspondence: Dr. Michelle M. Estrella, 4150 Clement St., Building 2, Room 145, San Francisco, CA 94121. Email: michelle.estrella@ucsf.edu
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ISSN:2641-7650
2641-7650
DOI:10.34067/KID.0003202022