Does adding the measurement of cystatin C to that of serum creatinine to determine estimated glomerular filtration rate improve its accuracy? That's the question asked by researchers who undertook a meta-analysis of 11 general population studies (90,750 participants) and five studies of cohorts with chronic kidney disease (2,960 participants) for whom standardized measurements of serum creatinine and cystatin C were available.
Researchers compared the association of the eGFR as calculated by the measurement of creatinine or cystatin C alone or in combination with creatinine, with the overall rate of death, death from cardiovascular causes, and end-stage renal disease.
Across all eGFR categories, the reclassification of the eGFR to a higher value with the measurement of cystatin C, as opposed to creatinine, was associated with a reduced risk of all three study outcomes; reclassification to a lower eGFR was associated with an increased risk.
The use of cystatin C - alone or in combination with creatinine - strengthens the association between eGFR and the risks of death and end-stage renal disease across diverse populations.
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The New England Journal of Medicine, 5 September 2013
[/style]http://www.nejm.org/doi/full/10.1056/NEJMoa1214234
