Different cardiovascular risks associated with elevated creatinine-based eGFR and cystatin C-based eGFR.

Area of Science:

• Nephrology
• Cardiology
• Epidemiology

Background:

• Estimated glomerular filtration rate (eGFR) is crucial for assessing kidney function.
• Two common markers, creatinine (eGFRcr) and cystatin C (eGFRcys), are used to estimate eGFR.
• The association of elevated eGFR with cardiovascular disease (CVD) and chronic kidney disease (CKD) risk requires further clarification.

Purpose of the Study:

• To compare the association of elevated eGFRcr and eGFRcys with the risk of incident CVD and CKD.
• To investigate differential risks associated with high kidney function estimates based on creatinine versus cystatin C.

Main Methods:

• A cohort study of 372,060 participants from the UK Biobank, initially free of CVD and CKD.
• Participants categorized into low, normal, and high eGFR groups based on age- and sex-specific percentiles.
• Primary outcome: incident CVD (ischemic heart disease, stroke, heart failure, atrial fibrillation) over a median 12.4-year follow-up.

Main Results:

• High eGFRcr was associated with a significantly higher risk of CVD (HR, 1.19).
• High eGFRcys was associated with a significantly lower risk of CVD (HR, 0.90).
• Both high eGFRcr and high eGFRcys were associated with a lower risk of CKD.

Conclusions:

• Elevated eGFRcr is linked to increased CVD risk, contrasting with eGFRcys which is linked to decreased CVD risk.
• Both markers of elevated kidney function are associated with a reduced risk of developing CKD.
• These findings highlight the importance of the eGFR estimation method in risk assessment for CVD and CKD.