Cystatin C and Prognosis for Cardiovascular and Kidney Outcomes in Elderly Persons without Chronic Kidney Disease

Shlipak, Michael G.; Katz, Ronit; Sarnak, Mark J.; Fried, Linda F.; Newman, Anne B.; Stehman‐Breen, Catherine; Seliger, Stephen L.; Kestenbaum, Brian; Psaty, Bruce M.; Tracy, Russell P.; Siscovick, David S.

doi:10.7326/0003-4819-145-4-200608150-00003

Cited by 474 publications

(371 citation statements)

References 39 publications

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“…Shlipak and colleagues have identified an early stage of kidney disease defined as elevated serum cystatin C in the absence of stage-3 through 5 chronic kidney disease 7 . This condition, "pre-clinical kidney disease", was demonstrated to be associated with an increased risk of chronic kidney disease progression and cardiovascular disease morbidity and mortality 7 .…”

mentioning

confidence: 99%

Overweight, Obesity, and Elevated Serum Cystatin C Levels in Adults in the United States

Muntner

Winston²,

Uribarri³

et al. 2008

The American Journal of Medicine

125

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confidence: 99%

Overweight, Obesity, and Elevated Serum Cystatin C Levels in Adults in the United States

Muntner

Winston²,

Uribarri³

et al. 2008

The American Journal of Medicine

125

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“…[2][3][4][5] The distinction between the 2 filtrating markers is pronounced in persons with eGFR greater than 60 mL/min (>1.00 mL/s); cystatin C level retains a strong association with cardiovascular risk in persons with eGFR greater than 60 mL/min (>1.00 mL/s), whereas creatinine level and eGFR have no significant association. 21 We previously showed that CKD, defined as creatinine clearance less than 60 mL/min (<1.00 mL/s), was associated with a 6-fold odds of poor exercise capacity in the Heart and Soul cohort compared with the highest creatinine clearance. 22 Our current study extends these findings by detecting a broader association of cystatin C level with decreased exercise capacity and poor HRR that extends to persons with pre-CKD.…”

Section: Discussionmentioning

confidence: 95%

Association of Cystatin C With Poor Exercise Capacity and Heart Rate Recovery: Data From the Heart and Soul Study

McManus

Shlipak

et al. 2007

American Journal of Kidney Diseases

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Background-Cystatin C, an alternative serum measure of kidney function, is a stronger predictor of cardiovascular events than creatinine or estimated glomerular filtration rate (eGFR). We hypothesized that serum cystatin C concentration would have a stronger more linear association with cardiovascular functional status than creatinine-based measures in outpatients with established coronary heart disease (CHD).

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“…This is relevant as new cut offs for diagnosing and classifying chronic kidney disease are being developed by the Kidney Disease: Improving Global Outcomes (KDIGO) (29). It is also relevant when considering results of studies examining cardiovascular risk or renal risk based on specific CysC/estimated GFR values (30,31). Clinical and laboratory experts need to work collaboratively to provide and understand method performance capabilities and measurement-uncertainty information necessary to meet clinical requirements.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Interlaboratory Differences in Cystatin C Assay Measurement on Glomerular Filtration Rate Estimation

White¹,

Rule²,

Collier³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Cystatin C (CysC) is a promising marker of GFR. Several equations have been derived to estimate GFR from its serum concentration. Heterogeneity in the performance of these equations exists in validation studies even when the same CysC assay from the same manufacturer is utilized. This study was designed to examine the differences in CysC and GFR estimation (eGFR) using Siemens' nephelometric immunoassay and the Mayo Clinic equation. The ability of the eGFRs to predict measured GFR was also examined.Design, setting, participants, & measurements Ninety-seven split samples were sent to laboratories at Children's Hospital of Eastern Ontario (CHEO) in Ottawa, Canada, and at the Mayo Clinic in Rochester, Minnesota. ResultsThe mean CHEO CysC was 0.17 mg/L (10%) lower than the mean Mayo Clinic CysC. Using the Mayo Clinic equation, the mean eGFR difference was 7.2 ml/min per 1.73 m 2 (15%). Approximately 36% of the results agreed within 10%, while 13% were discordant by greater than 30%. Larger absolute differences in mean eGFR between the two laboratories were found in the subgroup with CysC less than 1.41 mg/L as compared with the subgroup greater than 1.41 mg/L (9.5 versus 5.0 ml/min per 1.73 m 2 ). Correction of CHEO values to the Mayo Clinic did not improve GFR estimation. Conclusions Significant differences in CysC measurement exist between laboratories using the same assay by the same manufacturer and these lead to clinically relevant differences in GFR estimation. This interlaboratory variability needs to be recognized when interpreting and comparing CysC and eGFR results.

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Cystatin C and Prognosis for Cardiovascular and Kidney Outcomes in Elderly Persons without Chronic Kidney Disease

Cited by 474 publications

References 39 publications

Overweight, Obesity, and Elevated Serum Cystatin C Levels in Adults in the United States

Overweight, Obesity, and Elevated Serum Cystatin C Levels in Adults in the United States

Association of Cystatin C With Poor Exercise Capacity and Heart Rate Recovery: Data From the Heart and Soul Study

The Impact of Interlaboratory Differences in Cystatin C Assay Measurement on Glomerular Filtration Rate Estimation

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