Related Experiment Video

Updated: Jun 5, 2026

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection
10:15

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection

Published on: November 10, 2021

Cystatin C identifies chronic kidney disease patients at higher risk for complications

Carmen A Peralta1, Ronit Katz, Mark J Sarnak

  • 1San Francisco Veterans Affairs Medical Center, San Francisco, California, USA. carmenalicia.peralta@ucsf.edu

Journal of the American Society of Nephrology : JASN
|December 18, 2010
PubMed

Insights

Cystatin C may help identify patients with chronic kidney disease (CKD) at highest risk for complications. The adverse prognosis for CKD diagnosed by creatinine is mainly seen in those also identified by cystatin C.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Clinical Biomarkers

Background:

  • Chronic kidney disease (CKD) diagnosis and prognosis are critical for patient outcomes.
  • Creatinine-based estimated glomerular filtration rate (eGFR) is standard, but cystatin C offers a potentially stronger predictor.
  • The distinct clinical utility of cystatin C in CKD diagnosis and risk stratification remains unclear.

Purpose of the Study:

  • To evaluate the prognostic value of CKD diagnosis using creatinine, cystatin C, or both biomarkers.
  • To compare risks for mortality, cardiovascular events, heart failure, and end-stage renal disease (ESRD) based on CKD classification.

Main Methods:

  • Analysis of 11,909 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) and Cardiovascular Health Study (CHS).
  • CKD diagnosis defined as eGFR <60 ml/min per 1.73 m(2) using CKD-EPI equations for creatinine and cystatin C.
  • Participants categorized into mutually exclusive groups: CKD by creatinine only, cystatin C only, both, or neither.

Main Results:

  • In MESA, CKD by cystatin C only showed a significantly higher mortality risk (HR 3.23) compared to creatinine only (HR 0.80).
  • In CHS, CKD by cystatin C only (HR 1.78) and both (HR 1.74) had higher mortality risks than creatinine only (HR 1.09).
  • Similar patterns were observed for cardiovascular disease, heart failure, and kidney failure outcomes, highlighting cystatin C's prognostic role.

Conclusions:

  • Adverse prognosis in CKD diagnosed by creatinine is primarily confined to individuals also identified by cystatin C.
  • Cystatin C may enhance risk stratification for CKD patients, identifying those at highest risk for adverse events.
  • Integrating cystatin C into CKD assessment could refine clinical management and improve patient outcomes.

More Related Videos

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats05:34

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

Evaluation of Zebrafish Kidney Function Using a Fluorescent Clearance Assay08:13

Evaluation of Zebrafish Kidney Function Using a Fluorescent Clearance Assay

Published on: February 20, 2015

Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Nephrons01:10

Nephrons

The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma happens...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...