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Cited by 809Chronic Kidney Disease and DiabetesDialysis and Renal Disease ManagementClinical Laboratory Practices and Quality Control

Factors other than glomerular filtration rate affect serum cystatin C levels

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Stevens, Lesley A., Schmid, Christopher H., Greene, Tom, Li, Liang, Beck, Gerald J., Joffe, Marshall M., Froissart, Marc, Kusek, John W. +3 more·2009·Kidney International
DOI 10.1038/ki.2008.638PMC PMC4557800
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Abstract

Cystatin C is an endogenous glomerular filtration marker hence its serum level is affected by the glomerular filtration rate (GFR). To study what other factors might affect it blood level we performed a cross-sectional analysis of 3418 patients which included a pooled dataset of clinical trial participants and a clinical population with chronic kidney disease. The serum cystatin C and creatinine levels were related to clinical and biochemical parameters and errors-in-variables models were used to account for errors in GFR measurements. The GFR was measured as the urinary clearance of 125I-iothalamate and 51Cr-EDTA. Cystatin C was determined at a single laboratory while creatinine was standardized to reference methods and these were 2.1+/-1.1 mg/dL and 1.8+/-0.8 mg/L, respectively. After adjustment for GFR, cystatin C was 4.3% lower for every 20 years of age, 9.2% lower for female gender but only 1.9% lower in blacks. Diabetes was associated with 8.5% higher levels of cystatin C and 3.9% lower levels of creatinine. Higher C-reactive protein and white blood cell count and lower serum albumin were associated with higher levels of cystatin C and lower levels of creatinine. Adjustment for age, gender and race had a greater effect on the association of factors with creatinine than cystatin C. Hence, we found that cystatin C is affected by factors other than GFR which should be considered when the GFR is estimated using serum levels of cystatin C.

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Research works printed but not linked: 31

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Authors
Stevens, L. A., Schmid, C. H., Greene, T., Li, L., Beck, G. J., Joffe, M. M., Froissart, M., Kusek, J. W., Zhang, Y. (., Coresh, J., & Levey, A. S.
Affiliations
  • Tufts University (US)
  • University of Utah (US)
  • Cleveland Clinic (US)
  • University of Pennsylvania (US)
  • Université Paris Descartes (FR)
  • National Institutes of Health (US)
  • Johns Hopkins University (US)
Corresponding author
Stevens, Lesley A.
ORCID
Venue
Kidney International
Publisher
Elsevier BV
Published
2009-03
Volume
75
Issue
6
Pages
652-660
ISSN
0085-2538 (ISSN-L)
DOI
10.1038/ki.2008.638
PMC
PMC4557800
OpenAlex
W2010520337
Cited by
809
References
2
Citations by year
2026: 55 · 2025: 62 · 2024: 61 · 2023: 58 · 2022: 49 · 2021: 54 · 2020: 43 · 2019: 41 · 2018: 33 · 2017: 34 · 2016: 40 · 2015: 34 · 2014: 42 · 2013: 41 · 2012: 62
FWCI
36.87
Type
journal article
Language
en
Open access
Licence
Locations
  • Kidney International (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5u01dk053869-08, 5k23dk081017-03)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K23-DK-081017, U01-DK053869, U01 DK35073, U01DK067651, U01DK035073)
Topics
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Keywords
cystatin C, glomerular filtration rate, serum creatinine, chronic kidney disease, age, sex differences, racial differences, diabetes mellitus, C-reactive protein, white blood cell count, serum albumin, errors-in-variables models
MeSH terms
Age Factors, Creatinine, Cross-Sectional Studies, Female, Glomerular Filtration Rate, Humans, Kidney Function Tests, Male, Predictive Value of Tests, Sex Factors, Racial Groups, Cystatin C

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