Cystatin C Strengthens Link between Kidney Function and Risks for Death and Renal Failure

Using cystatin C alone or in combination with creatinine strengthened the association between the eGFR and risks of death and kidney failure in a NEJM meta-analysis of general-population studies (90,750 participants) and studies of CKD patients (2960 participants). In general-population cohorts, the prevalence of an eGFR of less than 60 mL/min/1.73 m² was higher with cystatin C–based eGFR than with creatinine-based eGFR (13.7% vs. 9.7%). Reclassification to a higher eGFR with cystatin C, as compared with creatinine, was associated with a reduced risk of kidney failure and death; reclassification to a lower eGFR was associated with an increased risk.