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Cystatin C as a marker of glomerular filtration rate: prospects and limitations

Lesley A Inker1, Aghogho Okparavero

  • 1Tufts Medical Center, Boston, Massachusetts 02111, USA. LInker@tuftsmedicalcenter.org

Current Opinion in Nephrology and Hypertension
|September 20, 2011
PubMed

Insights

Cystatin C shows potential for estimating glomerular filtration rate (GFR), but assay drift complicates results. Combining cystatin C with creatinine may serve as a confirmatory test for kidney function.

Area of Science:

  • Nephrology
  • Biomarker Analysis
  • Clinical Chemistry

Background:

  • Serum creatinine is the standard for estimating glomerular filtration rate (GFR).
  • Cystatin C is being investigated as an alternative or supplement to creatinine for GFR estimation.
  • Accurate GFR measurement is crucial for diagnosing and managing kidney disease.

Purpose of the Study:

  • To review the performance of cystatin C and combined creatinine-cystatin C equations for GFR estimation.
  • To compare these equations against creatinine-based equations in chronic and acute kidney disease.
  • To assess the clinical utility of cystatin C in various patient populations.

Main Methods:

  • Systematic review of published studies comparing GFR estimating equations.
  • Analysis of cystatin C assay performance and impact of assay drift.
  • Evaluation of equations in diverse cohorts including CKD, AKI, and specific patient groups.

Main Results:

  • Assay drift in cystatin C has significantly impacted reported results, though new reference materials may improve future consistency.
  • Current literature lacks a clear consensus on whether cystatin C-based equations outperform creatinine-based equations across all populations.
  • Cystatin C may be valuable as a confirmatory test when used alongside creatinine for GFR estimation.

Conclusions:

  • Cystatin C holds promise for GFR estimation in specific clinical scenarios.
  • Further research is needed to develop effective implementation strategies for cystatin C in clinical practice.
  • The combination of cystatin C and creatinine warrants further investigation for enhanced GFR assessment.
Abstract

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