Cystatin C versus Creatinine in Determining Risk Based on Kidney Function

In this meta-analysis of 16 studies, investigators evaluated the use of cystatin C, alone or with creatinine, to calculate the estimated glomerular filtration rate (eGFR). Measurement of cystatin C improved the prediction of outcomes in chronic kidney disease. The estimated glomerular filtration rat...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 369; no. 10; pp. 932 - 943
Main Authors: Shlipak, Michael G, Matsushita, Kunihiro, Ärnlöv, Johan, Inker, Lesley A, Katz, Ronit, Polkinghorne, Kevan R, Rothenbacher, Dietrich, Sarnak, Mark J, Astor, Brad C, Coresh, Josef, Levey, Andrew S, Gansevoort, Ron T
Format: Journal Article
Language:English
Published: Waltham, MA Massachusetts Medical Society 05.09.2013
Subjects:
Biological and medical sciences
Creatinine
Creatinine - blood
Cystatin C
Cystatin C - blood
Death
End-stage renal disease
Epidemiology
Epidermal growth factor receptors
General aspects
Glomerular Filtration Rate
Health and Welfare
Heart attacks
Humans
Hälsa och välfärd
Kidney diseases
Kidney Failure, Chronic - etiology
Kidney Function Tests
Medical prognosis
Medical sciences
Medical treatment
Population
Population studies
Reclassification
Reference Standards
Renal Insufficiency, Chronic - blood
Renal Insufficiency, Chronic - mortality
Renal Insufficiency, Chronic - physiopathology
Risk
Risk Assessment - methods
Systematic review
Medicine
Comparative study
Kidney
Risk factor
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In this meta-analysis of 16 studies, investigators evaluated the use of cystatin C, alone or with creatinine, to calculate the estimated glomerular filtration rate (eGFR). Measurement of cystatin C improved the prediction of outcomes in chronic kidney disease. The estimated glomerular filtration rate (eGFR) is the clinical standard for the assessment of kidney function. 1 – 3 The eGFR thresholds for the definition and staging of chronic kidney disease are based on risk, 3 but measurement of creatinine to determine the eGFR has limitations in risk prediction, particularly in patients with reduced muscle mass. 4 Cystatin C has received much attention as an alternative filtration marker with stronger and more linear risk relationships than creatinine. 5 – 7 Several studies have suggested that the addition of cystatin C measurements to creatinine measurements in calculating the eGFR significantly improves the risk classification for death, cardiovascular . . .
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The authors’ affiliations are listed in the Appendix.
A complete list of members of the Chronic Kidney Disease (CKD) Prognosis Consortium is provided in the Supplementary Appendix, available at NEJM.org.
ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1214234