When kidney filtration estimates disagree, health risks may differ
A cohort meta-analysis linked lower cystatin C estimates, relative to creatinine estimates, with higher death rates and other adverse outcomes.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Among outpatients, a substantially lower kidney filtration estimate from cystatin C than from creatinine was associated with higher death rates during follow-up. Associations also appeared for cardiovascular events and kidney failure requiring replacement therapy. The study identifies a pattern linked to risk; it does not show that the disagreement itself causes harm.
This abstract-based summary cannot assess how fully other explanations were addressed. Outcome associations were reported for outpatients; they should not automatically be extended to hospitalized patients.
What researchers found
Hazard ratio for death from any cause
During average follow-up of 11 years in outpatients: cystatin C estimate at least 30% below creatinine estimate versus a difference between -30% and 30%.
What disagreement meant
The researchers compared kidney filtration estimates calculated from creatinine and cystatin C measured at the same time. Their main focus was a markedly lower cystatin C estimate, rather than any difference between tests.
Deaths over observation time
Death rates were 28.4 with marked disagreement versus 16.8 in the reference group per 1000 person-years. Person-years combine participants' observation time; these group rates do not give an individual's probability of dying.
The original publication
Discordance in Creatinine- and Cystatin C-Based eGFR and Clinical Outcomes: A Meta-Analysis.
Estrella MM, Ballew SH, Sang Y et al.
JAMA · 2025
- PubMed ID
- 41202182
- Record checked
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