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cystatin C in serum/plasma

Indications: - assessment of renal function, renal insufficiency (GFR) Clinical significance: - levels affected by thyroid function, diabetes mellitus, inflammation, glucocorticoids, malignancy, HIV1 infection [5] - useful in elderly & patients with cirrhosis [5] - sensitive to small changes in GFR - less sensitive than serum creatinine to changes in muscle mass [5] - for some patients cystatin C-based measures of GFR may be more accurate than creatinine-based measures [8] - cystatin C-based measures may have prognostic value - adverse outcomes, including ESRD, cardiovacular events & mortality, are more common when cystatin C-based measurements of GFR are signficantly lower than creatinine-based measures [8] Notes: - not widely used. - component of Berlin Initiative Study equation, for estimating GFR in elderly [4]

Related

cystatin 3 (cystatin-C, CST3)

General

renal function tests; renal function panel

References

  1. Inker LA et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012 Jul 5; 367:20. PMID: 22762323 - Weir MR. Improving the estimating equation for GFR - A clinical perspective. N Engl J Med 2012 Jul 5; 367:75. PMID: 22762323
  2. Cystatin C Lab Tests Online: cystatin_c
  3. Cystatin C Laboratory Test Directory ARUP: 95229
  4. Schaeffner ES et al Two Novel Equations to Estimate Kidney Function in Persons Aged 70 Years or Older Ann Intern Med. 2 October 2012;157(7):471-481 PMID: 23027318 http://annals.org/article.aspx?articleid=1363512
  5. Medical Knowledge Self Assessment Program (MKSAP) 17, 18, American College of Physicians, Philadelphia 2015, 2018
  6. Baxmann AC, Ahmed MS, Marques NC et al Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol. 2008 Mar;3(2):348-54. PMID: 18235143 Free PMC Article
  7. Shlipak MG, Inker LA, Coresh J Serum Cystatin C for Estimation of GFR JAMA. Published online August 8, 2022 PMID: 35939309 https://jamanetwork.com/journals/jama/fullarticle/2795292
  8. Carrero JJ et al. Discordances between creatinine- and cystatin C-based estimated GFR and adverse clinical outcomes in routine clinical practice. Am J Kidney Dis 2023 Nov; 82:534. PMID: 37354936 Free article https://www.ajkd.org/article/S0272-6386(23)00691-1/fulltext - Pinsino A et al. The difference between cystatin C-and creatinine-based estimated GFR in heart failure with reduced ejection fraction: Insights from PARADIGM-HF. Am J Kidney Dis 2023 Nov; 82:521. PMID: 37086965 https://www.ajkd.org/article/S0272-6386(23)00609-1/fulltext - Grubb AO et al. Etiologic and diagnostic implications of morbidity and mortality associations when cystatin C-based estimated GFR is lower than creatinine-based estimated GFR. Am J Kidney Dis 2023 Nov; 82:509. PMID: 37737748 https://www.ajkd.org/article/S0272-6386(23)00778-3/fulltext