ASN: Large Gap Between Creatinine-Based eGFR and Cystatin C-Based eGFR Tied to Worse Outcomes

MONDAY, Nov. 10, 2025 (HealthDay News) — In the outpatient setting, the presence of a cystatin C-based estimated glomerular filtration rate (eGFRcys) that is at least 30 percent lower than creatinine-based eGFR (eGFRcr) is associated with significantly higher rates of all-cause mortality, cardiovascular events, and kidney failure, according to a study published online Nov. 7 in the Journal of the American Medical Association to coincide with Kidney Week, the annual meeting of the American Society of Nephrology, held from Nov. 5 to 9 in Houston.

Michelle M. Estrella, M.D., from the University of California San Francisco, and colleagues examined the prevalence of a discordance between eGFRcys and eGFRcr among participants in the Chronic Kidney Disease Prognosis Consortium.

The analyses included 821,327 individuals from 23 outpatient cohorts and 39,639 individuals from two inpatient cohorts. The researchers found that 11 and 35 percent of the outpatient participants and inpatients, respectively, had a large negative eGFR difference (eGFRdiff). Compared with an eGFRdiff between −30 and 30 percent, a large negative eGFRdiff was associated with higher rates of all-cause mortality, cardiovascular mortality, atherosclerotic cardiovascular disease, heart failure, and kidney failure with replacement therapy (hazard ratios, 1.69, 1.61, 1.35, 1.54, and 1.29, respectively) among outpatient participants at a mean follow-up of 11 years.

“Our findings highlight the importance of measuring both creatinine and cystatin C to gain a true understanding of how well the kidneys are working, particularly among older and sicker adults,” coauthor Morgan Grams, M.D., Ph.D., from the New York University Grossman School of Medicine in New York City, said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

Abstract/Full Text

Editorial

More Information