Cystatin C as a marker of glomerular filtration rate: prospects and limitations.
Curr Opin Nephrol Hypertens 2012;
20:631-9. [PMID:
21926620 DOI:
10.1097/mnh.0b013e32834b8850]
[Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW
There is much interest in cystatin C to replace or supplement serum creatinine to estimate the glomerular filtration rate (GFR). Here we review the performance of cystatin C and combined creatinine-cystatin C estimating equations compared to creatinine-based estimating equations in chronic and acute kidney disease.
RECENT FINDINGS
Drift in the cystatin C assay has had a large effect on the results reported using cystatin C, but these issues are not routinely considered in evaluation of GFR-estimating equations. The recently released primary reference material for cystatin C will allow less difference among assays in the future. There does not appear to be a consistent message among published studies as to whether cystatin C-based equations are better than creatinine-based equations in the general population or those with chronic kidney disease (CKD), as well as those with reduced muscle mass or chronic illness, or acute kidney injury. Cystatin C could be used in combination with creatinine as a confirmatory test for estimated GFR from creatinine.
SUMMARY
Cystatin C may have a role to estimate GFR in selected circumstances, and the next set of studies should be directed at developing implementation strategies for its use.
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