Related Experiment Video
Updated: May 19, 2026
Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
Published on: December 16, 2022
Association Between Differences in Estimated GFR by Creatinine Vs. Cystatin C and Stroke Outcomes: Results From the
Qi Huang1, Yuesong Pan2,3,4,5,6, Hongyi Yan3,4,5,6
1Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Significant differences in estimated glomerular filtration rates (eGFRdiff) between cystatin C- and creatinine-based measures are linked to worse stroke outcomes. Monitoring these eGFR differences is crucial for managing stroke patients.
Area of Science:
- Nephrology
- Neurology
- Cardiovascular Medicine
Background:
- The prognostic significance of differences between cystatin C- and creatinine-based estimated glomerular filtration rates (eGFRdiff) in stroke patients remains unclear.
- This study aimed to investigate the association between eGFRdiff and stroke prognosis.
Purpose of the Study:
- To determine the impact of eGFRdiff on long-term outcomes following ischemic stroke or transient ischemic attack.
- To assess the relationship between absolute and ratio differences in eGFR and post-stroke mortality, disability, and recurrence.
Main Methods:
- A prospective cohort study of 10,293 participants from the Third China National Stroke Registry was conducted.
- eGFRdiff was calculated using absolute difference (eGFRabdiff) and ratio (eGFRrediff) between cystatin C-based (eGFRcys) and creatinine-based (eGFRcr) estimates.
- Time-updated changes in eGFRdiff (ΔeGFRdiff) were analyzed, with outcomes assessed over 5 years.
Main Results:
- 35.2% of participants had eGFRabdiff < -15 mL/min/1.73 m² and 3.5% had eGFRrediff < 0.6.
- eGFRabdiff < -15 mL/min/1.73 m² was associated with increased odds of disability (OR 1.19) and mortality (HR 1.28).
- eGFRrediff < 0.6 showed higher risks for disability (OR 1.66) and mortality (HR 1.49); significant ΔeGFRdiff declines also increased mortality risk.
Conclusions:
- Significant and widening eGFRdiff are independently associated with increased risks of post-stroke disability and mortality.
- Monitoring both eGFRcys and eGFRcr is important for comprehensive stroke management and prognosis assessment.
Background:
The effect of the difference between cystatin C- and creatinine-based estimated glomerular filtration rates (eGFRdiff) on stroke outcomes is unclear. This study investigated the association between eGFRdiff and stroke prognosis.
Methods:
Participants with ischaemic stroke or transient ischaemic attack were recruited from the Third China National Stroke Registry, a multicenter, prospective cohort. eGFRdiff was calculated using the absolute difference (eGFRabdiff defined as cystatin C-based (eGFRcys) minus creatinine-based (eGFRcr)) and the ratio (eGFRrediff) between eGFRcys and eGFRcr estimates. eGFRabdiff (< -15, -15-15, ≥ 15 mL/min/1.73 m2) and eGFRrediff (< 0.6, ≥ 0.6) were analyzed. Time-updated eGFRdiff (ΔeGFRdiff) was defined as the change from baseline to 1-year blood re-examination and tertiled. Outcomes included 5-year all-cause mortality, stroke disability, and stroke recurrence.
Results:
Among 10,293 participants, 35.2% had an eGFRabdiff < -15 mL/min/1.73 m2, and 3.5% had an eGFRrediff < 0.6. Compared with midrange eGFRabdiff, participants with eGFRabdiff < -15 mL/min/1.73 m2 had an odds ratio (OR) of 1.19 (95% confidence interval (CI), 1.05-1.35) for disability and a hazard ratio (HR) of 1.28 (95% CI, 1.12-1.46) for mortality. eGFRrediff < 0.6 was associated with a higher risk for disability (OR, 1.66; 95% CI, 1.25-2.19) and mortality (HR, 1.49; 95% CI, 1.17-1.90). Participants with the largest ΔeGFRdiff declines had higher mortality (OR, 1.44; 95% CI, 1.14-1.82) and borderline disability risk significance (HR, 1.25; 95% CI, 0.96-1.61).
Conclusions:
Significant and widening eGFRdiff were independently associated with increased risks of post-stroke disability and mortality, highlighting the importance of monitoring eGFRcys and eGFRcr in stroke management.
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 Serum Creatinine Concentration and Clearance
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
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...
01:28Chronic Kidney Disease III: Interprofessional Care
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention