Serum Cystatin C for Estimation of GFR

Shlipak, Michael G.; Inker, Lesley A.; Coresh, Josef

doi:10.1001/jama.2022.12407

Cited by 23 publications

(11 citation statements)

References 6 publications

(20 reference statements)

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“…Data suggest that an equation that incorporates both creatinine and cystatin (i.e., eGFRcr-cys) performs best in this situation. 39 Our study has many strengths. Notably, the prospective ARIC cohort included a large sample size and nearly 30 years of follow-up, providing detailed insights into eGFR trends and comparisons between eGFRcr and eGFRcys over time and with an aging population.…”

Section: Discussionmentioning

confidence: 99%

Discrepancies between Cystatin C–Based and Creatinine-Based eGFR

Farrington

Surapaneni

Matsushita

et al. 2023

CJASN

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Background: Recent guidance suggests clinicians increase use of cystatin C for the estimation of glomerular filtration rate. Discrepant levels of creatinine vs. cystatin C-based estimated glomerular filtration rate (eGFRcr vs eGFRcys) can occur and might signify inaccurate estimation of eGFR using creatinine alone. This study sought to enhance the knowledge of the risk factors and clinical implications of having a large eGFR discrepancy. Methods: Participants in the Atherosclerosis Risk in Communities (ARIC) Study, a prospective cohort study of US adults followed over 25 years. eGFR discrepancy was measured at five clinical visits and defined as eGFRcys either 30% lower or higher than eGFRcr, the current clinical standard of care. The associations between eGFR discrepancies and kidney-related laboratory parameters were assessed using linear and logistic regression and long-term adverse outcomes, including kidney failure, acute kidney injury, heart failure and death, using Cox proportional hazards models. Results: Among 13,197 individuals (mean age 57 (SD 6) years, 56% women, 25% Black race), 7% had eGFRcys 30% lower than eGFRcr at Visit 2 (1990-1992), and this proportion increased over time to 23% by Visit 6 (2016-2017). In contrast, the percent with eGFRcys 30% higher than eGFRcr was relatively stable (3% to 1%). Independent risk factors for having eGFRcys 30% lower than eGFRcr included older age, female sex, non-Black race, higher eGFRcr, higher BMI, weight loss, and current smoking. Those with eGFRcys 30% lower than eGFRcr had more anemia and higher uric acid, FGF23, and phosphate levels as well as higher risk of subsequent mortality, kidney failure, acute kidney injury, and heart failure compared to those with similar eGFRcr and eGFRcys values. Conclusions: Having eGFRcys lower than eGFRcr was associated with worse kidney-related laboratory derangements and a higher risk of adverse health outcomes.

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Section: Discussionmentioning

confidence: 99%

Discrepancies between Cystatin C–Based and Creatinine-Based eGFR

Farrington

Surapaneni

Matsushita

et al. 2023

CJASN

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“…Serum Cyc-C and NGAL are related to renal injury [ 14 , 15 ], and our data show that obese mice demonstrated significantly increased levels in comparison to CD-fed mice. Notably, aerobic exercise resulted in a reduction in serum Cyc-C and NGAL levels in obese mice ( Figure 2D, E ).…”

Section: Resultsmentioning

confidence: 82%

Aerobic exercise attenuates high-fat diet–induced renal injury through kidney metabolite modulation in mice

Xiong,

Luan,

Yuan

et al. 2024

Renal Failure

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Purpose To investigate the preventive effect of aerobic exercise on renal damage caused by obesity. Methods The mice in the Control (Con) and Control + Exercise (Con + Ex) groups received a standard chow diet for the 21-week duration of the study, while the High-fat diet (HFD) group and High-fat diet + Exercise (HFD + Ex) group were fed an HFD. Mice were acclimated to the laboratory for 1 week, given 12 weeks of being on their respective diets, and then the Con + Ex and HFD + Ex groups were subjected to moderate intensity aerobic treadmill running 45 min/day, 5 days/week for 8 weeks. Results We found that HFD-induced obesity mainly impacts kidney glycerin phospholipids, glycerides, and fatty acyls, and aerobic exercise mainly impacts kidney glycerides, amino acids and organic acids as well as their derivatives. We identified 18 metabolites with significantly altered levels that appear to be involved in aerobic exercise mediated prevention of HFD-induced obesity and renal damage, half of which were amino acids and organic acids and their derivatives. Conclusion Aerobic exercise rewires kidney metabolites to reduce high-fat diet-induced obesity and renal injury.

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“…Its gene is transcribed and expressed consistently in all organs, including the kidney, liver, pancreas, intestine, stomach, lung, and placenta (15). Its blood concentration fluctuates independently of inflammation, infection, tumor, and liver function, as well as sex, nutrition, body surface area, and muscle mass, making it an effective endogenous marker for reflecting glomerular filtration rate changes (16). It has been shown that CysC is closely associated with the prognosis of a variety of diseases, including coronary heart disease, vascular disease, and stroke (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

New predictive biomarkers for screening COVID-19 patients with rhabdomyolysis in combination with cystatin C

Yu,

Zhang,

Wan

et al. 2023

Shock

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Purpose Cystatin C (CysC) has been linked to the prognosis of Corona Virus Disease 2019 (COVID-19). The study aims to investigate a predictor correlated with CysC screening for poor prognosis in COVID-19 patients combined with skeletal muscle (SKM) impairment and rhabdomyolysis (RM). Methods A single-center retrospective cohort analysis was carried out. Demographic information, clinical data, laboratory test results, and clinical outcome data were gathered and analyzed. Results According to the inclusion and exclusion criteria, 382 patients were included in this study. The subjects were divided into three groups based on CysC tertiles. Multivariate analysis revealed that SaO2 (HR 0.946, 95%CI: 0.906-0.987, P = 0.011), CysC (HR 2.124, 95%CI: 1.223-3.689, P = 0.008), AST (HR 1.009, 95%CI. 1.000-1.018, P = 0.041), and hypersensitive CRP (HR 1.005, 95%CI: 1.000-1.010, P = 0.045) were significantly associated with survivals. The area under curve (AUC) in the model characterized by RM incidence was 0.819 (0.698-0.941), as shown by CysC ROC curves. LDH*CysC and AST*CysC had better predictive values than CysC, and the best prediction for RM, with an AUC of 0.880 (0.796,0.964) for LDH*CysC (P<0.05, vs CysC) and 0.925 (0.878,0.972) for AST*CysC (P<0.05, vs CysC). Conclusion CysC is an essential evaluation indicator for COVID-19 patients’ prognosis. AST*CysC and LDH*CysC have superior predictive value to CysC for SKM, RM, and death, and optimal classification for RM.

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Serum Cystatin C for Estimation of GFR

Cited by 23 publications

References 6 publications

Discrepancies between Cystatin C–Based and Creatinine-Based eGFR

Discrepancies between Cystatin C–Based and Creatinine-Based eGFR

Aerobic exercise attenuates high-fat diet–induced renal injury through kidney metabolite modulation in mice

New predictive biomarkers for screening COVID-19 patients with rhabdomyolysis in combination with cystatin C

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