- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Estimated GFR based on creatinine, cystatin C more strongly associates with CV events for older adults: Study
Sweden: A recent study has shown low estimated glomerular filtration rate based on both creatinine and cystatin C (eGFRcr-cys) is more strongly and uniformly associated with adverse outcomes compared with low estimates based on creatinine alone (eGFRcr) in older patients.
The findings, published in the Annals of Internal Medicine, highlight the benefit of including cystatin C in GFR estimation.
The commonly accepted threshold of GFR to define chronic kidney disease (CKD) is less than 60 mL/min/1.73 m2. This threshold is partly based on associations between estimated GFR and the frequency of adverse outcomes. In older adults, the associations are weaker, which has created disagreement about the appropriateness of the threshold for these persons. In addition, the studies measuring these associations included relatively few outcomes and estimated GFR based on creatinine level, which may be less accurate in older adults.
Against the above background, Edouard L. Fu, Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden, and colleagues aimed to evaluate associations in older adults between eGFRcr versus eGFR based on creatinine and cystatin C levels and eight outcomes in a population-based cohort study conducted in Stockholm, Sweden from 2010 to 2019.
The study included 82,154 participants aged 65 years or older with outpatient creatinine and cystatin C testing. Hazard ratios were calculated for cardiovascular mortality, all-cause mortality, and kidney failure with replacement therapy (KFRT). Incidence rate ratios were calculated for recurrent hospitalizations, myocardial infarction or stroke, infection, heart failure, and acute kidney injury.
The study led to the following findings:
- The associations between eGFRcr-cys and outcomes were monotonic, but most associations for eGFRcr were U-shaped.
- eGFRcr-cys was more strongly associated with outcomes than eGFRcr. For example, the adjusted hazard ratios for 60 versus 80 mL/min/1.73 m2 for all-cause mortality were 1.2 for eGFRcr-cys and 1.0 for eGFRcr, and for KFRT they were 2.6 and 1.4, respectively.
- Similar findings were observed in subgroups, including those with a urinary albumin–creatinine ratio below 30 mg/g.
"Estimated glomerular filtration rate based on both creatinine and cystatin C was more strongly and uniformly associated with cardiovascular events than estimates based on creatinine alone," the researchers wrote.
Nearly one-third of individuals were reclassified into a different severity category after recalculation.
Reference:
Fu EL, Carrero JJ, Sang Y, Evans M, Ishigami J, Inker LA, Grams ME, Levey AS, Coresh J, Ballew SH. Association of Low Glomerular Filtration Rate With Adverse Outcomes at Older Age in a Large Population With Routinely Measured Cystatin C. Ann Intern Med. 2024 Jan 30. doi: 10.7326/M23-1138. Epub ahead of print. PMID: 38285982.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751