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Evaluating the Diagnostic Utility of Cystatin C versus Creatinine in Chronic Kidney Disease: A Cross-Sectional

Pallavi Sagar1, Ravi Shekhar2, Bandana Kumari1

  • 1Biochemistry, All India Institute of Medical Sciences, Patna, IND.

Cureus
|January 8, 2026
PubMed

Insights

Serum cystatin C is a sensitive biomarker for chronic kidney disease (CKD) detection, showing better correlation with estimated glomerular filtration rate (eGFR) than creatinine. Integrating cystatin C can improve early CKD diagnosis in Indian patients.

Area of Science:

  • Nephrology
  • Biomarker Discovery
  • Clinical Diagnostics

Background:

  • Chronic kidney disease (CKD) is prevalent in India, often linked to diabetes and hypertension.
  • Serum creatinine, a traditional biomarker, has limitations in early CKD detection due to non-renal factor influences.
  • Serum cystatin C offers a promising alternative, unaffected by muscle mass or diet.

Purpose of the Study:

  • To evaluate the diagnostic utility of serum cystatin C compared to serum creatinine for CKD detection and monitoring in Indian patients.
  • To assess the correlation of cystatin C and creatinine with estimated glomerular filtration rate (eGFR).

Main Methods:

  • A cross-sectional study involving 150 participants (75 CKD patients, 75 controls) at Indira Gandhi Institute of Medical Sciences, Patna.
  • Serum cystatin C measured by ELISA; serum creatinine by kinetic Jaffe method.
  • Calculated eGFR using CKD-EPI equations based on both biomarkers (eGFRCr-Cys, eGFRCr, eGFRCys).

Main Results:

  • Both cystatin C and creatinine were significantly elevated in CKD patients (p<0.0001).
  • Cystatin C demonstrated a stronger negative correlation with eGFRCr-Cys (r = -0.91) than creatinine (r = -0.896).
  • High concordance (r = 0.90) between eGFRCr-Cys and eGFRCr was observed, especially in diabetic and early-stage CKD subgroups.

Conclusions:

  • Serum cystatin C is a sensitive and reliable biomarker for CKD detection, outperforming creatinine in correlation with eGFRCr-Cys.
  • Cystatin C is particularly valuable for early CKD diagnosis and in high-risk populations.
  • Routine integration of cystatin C could enhance early diagnosis and patient outcomes, despite cost and availability barriers.
Abstract

Keywords:
biomarkerschronic kidney diseasecreatininecystatin cearly diagnosisegfr

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