JAMA

Kidney Week 2025: Discordant creatinine and cystatin C-based eGFRs may signal higher risk

November 14, 2025

A meta-analysis of 860,966 patients from the CKD Prognosis Consortium found that when cystatin C–based eGFR (eGFR_cys) is ≥30% lower than creatinine-based eGFR (eGFR_cr), outpatients experience significantly higher all-cause mortality (hazard ratio [HR], 1.69), CV mortality (HR, 1.61), ASCVD (HR, 1.35), heart failure (HR, 1.54), and kidney failure requiring replacement therapy (HR, 1.29) over ~11 years. In the analysis, 11% of outpatients and 35% of hospitalized individuals had an eGFR based on cystatin C that was at least 30% lower than their creatinine-based eGFR. These findings were presented at the American Society of Nephrology (ASN) Kidney Week meeting.

Source:

Estrella MM, et al; Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators. (2025, November 7). JAMA. Discordance in Creatinine- and Cystatin C-Based eGFR and Clinical Outcomes: A Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/41202182/