Related Experiment Video
Updated: Mar 29, 2026
A High-throughput Method for Measurement of Glomerular Filtration Rate in Conscious Mice
Published on: May 10, 2013
Discrepancy between cystatin C-based and creatinine-based eGFR predicts all-cause mortality in a community-based
Takaya Suzuki1, Kazunobu Ichikawa1, Natsuko Suzuki2,3
1Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Insights
The difference between cystatin C-based and creatinine-based kidney function estimates predicts all-cause mortality in Japanese adults. This eGFR difference is a simple marker for identifying individuals at higher risk of death.
Area of Science:
- Nephrology
- Epidemiology
- Gerontology
Background:
- Discrepancies between cystatin C-eGFR (eGFRcys) and creatinine-eGFR (eGFRcr) are linked to adverse outcomes in Western populations.
- Prognostic significance of eGFR discrepancies in community-dwelling Japanese individuals is not well understood.
Purpose of the Study:
- To evaluate the association between eGFR discrepancies and mortality in a Japanese cohort.
- To determine if eGFRdiff is an independent predictor of all-cause and cardiovascular mortality.
Main Methods:
- Prospective cohort study of 1308 Japanese participants with simultaneous eGFRcys and eGFRcr measurements.
- Categorization of eGFR discrepancy (eGFRdiff = eGFRcys - eGFRcr) into low (< -10), reference (-10 to 10), and high (≥ 10) groups.
- Assessment of all-cause and cardiovascular mortality using survival analyses over a median follow-up of 18.5 years.
Main Results:
- A total of 386 deaths (29.5%) occurred, including 120 cardiovascular deaths.
- The low eGFRdiff group (< -10) showed significantly higher all-cause mortality (HR: 1.41; 95% CI: 1.10-1.80).
- The high eGFRdiff group (≥ 10) showed a lower risk of all-cause mortality (HR: 0.56; 95% CI: 0.33-0.97).
- eGFRdiff improved discrimination for both all-cause and cardiovascular mortality when added to baseline models.
Conclusions:
- eGFR discrepancy is an independent predictor of all-cause mortality in community-dwelling Japanese individuals.
- eGFRdiff serves as a simple and informative marker for identifying individuals at increased risk of death.
- Further research may explore the clinical utility of eGFRdiff in risk stratification.
Background:
Discrepancies between the cystatin C-based estimated glomerular filtration rate (eGFRcys) and the creatinine-based estimated glomerular filtration rate (eGFRcr) have been linked to adverse outcomes in Western populations. However, their prognostic significance in community-dwelling Japanese individuals remains unclear. Therefore, we conducted a prospective cohort study to evaluate this association.
Methods:
We analyzed data from 1308 participants who underwent simultaneous measurements of serum creatinine and cystatin C levels between 2004 and 2006, with a median follow-up of 18.5 years. The discrepancy (eGFRdiff = eGFRcys - eGFRcr) was categorized into three groups: a low group (< - 10 mL/min/1.73 m2), a reference group (- 10 to 10 mL/min/1.73 m2), and a high group (≥ 10 mL/min/1.73 m2). All-cause and cardiovascular mortality were assessed using Kaplan-Meier curves, Cox proportional hazards models, and restricted cubic spline analyses.
Results:
During the follow-up period, 386 participants (29.5%) died, including 120 cardiovascular-related deaths. Compared with the reference group, individuals in the eGFRdiff < - 10 group exhibited a significantly higher risk of all-cause mortality (hazard ratio [HR]: 1.41; 95% confidence interval [CI]: 1.10-1.80), whereas those in the ≥ 10 group showed a lower risk (HR: 0.56; 95% CI: 0.33-0.97). No significant association was observed with cardiovascular mortality. Incorporating eGFRdiff into the baseline models improved discrimination for both all-cause and cardiovascular mortality.
Conclusion:
The discrepancy between eGFRcys and eGFRcr levels is an independent predictor of all-cause mortality in a community-based Japanese population. eGFRdiff may serve as a simple yet informative marker for identifying individuals at increased risk of death.
Related Concept Videos
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
01:23Renal Clearance
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...