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Advantages, Limitations, and Clinical Considerations in Using Cystatin C to Estimate GFR
Debbie C Chen1, O Alison Potok2, Dena Rifkin2
1Kidney Health Research Collaborative, University of California, San Francisco and San Francisco VA Health Care System, San Francisco, California.
Cystatin C is a reliable kidney function marker, recommended by guidelines for diagnosing chronic kidney disease (CKD) and improving clinical decisions. Its use is increasing to ensure accurate kidney function assessment.
Area of Science:
- Nephrology
- Clinical Chemistry
- Biomarkers
Background:
- Cystatin C is recognized as an accurate marker of kidney function across various populations.
- Guidelines like KDIGO (2012) recommend cystatin C for confirming chronic kidney disease (CKD) and for precise kidney function estimation in clinical decision-making.
- Recent US initiatives aim to remove race from estimated glomerular filtration rate (eGFR) calculations, promoting cystatin C's adoption.
Purpose of the Study:
- To review and synthesize existing literature on cystatin C as a kidney function marker.
- To evaluate the evidence supporting cystatin C's use in CKD diagnosis and risk stratification.
- To discuss practical challenges and provide guidance for clinicians on interpreting cystatin C results.
Main Methods:
- Literature review and synthesis of studies on cystatin C.
- Analysis of evidence supporting current clinical guidelines and recommendations.
- Discussion of clinical implementation challenges and interpretation strategies.
Main Results:
- Cystatin C offers advantages as a kidney function marker, particularly in diverse populations.
- Evidence supports its role in confirming CKD and risk stratification for adverse outcomes.
- Challenges in clinical adoption and interpretation exist but can be addressed.
Conclusions:
- Cystatin C is a valuable tool for assessing kidney function, supporting CKD diagnosis, and risk stratification.
- Increased clinical adoption of cystatin C is recommended to enhance kidney function assessment accuracy.
- Understanding its advantages, limitations, and interpretation is crucial for effective clinical use.
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