Use of Cystatin C to Assess Kidney Function

How Is Chronic Kidney Disease (CKD) Defined?

August 2011

There are 2 ways that a person can be diagnosed with chronic kidney disease. The first criterion requires the presence of kidney damage for more than 3 months, as defined by structural or functional abnormalities, with or without any decrease in GFR. This could include pathological abnormalities confirmed on a kidney biopsy. Alternatively,  markers other than an elevated creatinine can indicate kidney damage on lab testing. An example would be an abnormal urinalysis. The second criterion for chronic kidney disease is a little simpler. Anyone with a GFR less than 60 mL per minute per 1.73 m² meets criterion for chronic kidney disease.

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Jump to section:

• Introduction
• A Case
• Questions
• What do the kidneys do?
• Why Measure Renal Function?
• How Is Chronic Kidney Disease (CKD) Defined?
• Stages of Chronic Kidney Disease
• Laboratory Assessment of Kidney Function: What Can We Measure?
• Creatinine as a Marker of GFR
• Creatinine as a Marker of GFR: It Works But...
• How Can We Turn the Serum Creatinine Into a Better Estimate of GFR?
• Revised eGFR Equation (ID-MS version)
• eGFR Equation Works, But it's Not Perfect
• What About Cystatin C?
• Mayo Renal Laboratory Cystatin C By Particle Enhanced Turbidometric Immunoassay (PETIA)
• Comparison To Current Nephelometric Assay (PENIA) Reveals 23% Bias
• Cystatin C PENIA Assay Shift (19%)
• Cystatin C eGFR Using Published Equation* Performs Well³
• Cystatin C Equations Categorize Patients Slightly Better Than MDRD eGFR
• Cystatin C Reference Range
• PETIA Cystatin C Reference Range
• Cystatin C: Useful To Confirm Those At Risk Of CKD Progression And Its Complications (REGARDS)⁴
• Cystatin C: CKD Progression and Complications (MESA and CHS)⁵
• Cystatin C in the Acute Hospitalized Setting⁶
• Back to Our Patient
• Potential Interventions
• Conclusions
• References
• Questions?