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Updated: Jun 2, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Relationship between serum cystatin C and hypertension among US adults without clinically recognized chronic kidney

Anoop Shankar1, Srinivas Teppala

  • 1Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV, USA. ashankar@hsc.wvu.edu

Journal of the American Society of Hypertension : JASH
|April 19, 2011
PubMed

Insights

Mildly reduced kidney function, indicated by higher serum cystatin C, is linked to hypertension in women but not men, even before chronic kidney disease (CKD) is clinically apparent.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Animal studies suggest a link between reduced renal function and hypertension.
  • Few human studies have investigated this association, particularly in individuals without clinically recognized chronic kidney disease (CKD).
  • Serum cystatin C is a marker of glomerular filtration rate (GFR).

Purpose of the Study:

  • To examine the association between serum cystatin C levels and hypertension in US adults without clinically recognized CKD.
  • To determine if this association differs between men and women.

Main Methods:

  • Analysis of data from the National Health and Nutrition Examination Survey (1999-2002) on 2583 US adults (>20 years).
  • Exclusion of participants with estimated GFR <60 mL/min/1.73 m² or microalbuminuria.
  • Hypertension defined by medication use or blood pressure thresholds (≥140/90 mm Hg).
  • Serum cystatin C levels categorized into quartiles; multivariable adjustments performed.

Main Results:

  • Higher serum cystatin C levels were significantly associated with hypertension in women (OR 2.04, 95% CI 1.13-3.69 for Q4 vs Q1; P trend = .02).
  • No significant association was found between serum cystatin C levels and hypertension in men (OR 0.86, 95% CI 0.53-1.41; P trend = .51).
  • These findings persisted after adjusting for multiple confounding factors.

Conclusions:

  • Mildly reduced kidney function, as indicated by elevated serum cystatin C, is associated with hypertension in US women without clinically recognized CKD.
  • This association was not observed in men.
  • Serum cystatin C may serve as an early indicator of hypertension risk in women, independent of established CKD markers.

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