Use of Cystatin C to Assess Kidney Function
Patients with chronic kidney disease are now classified into 5 stages. Persons in stage 1 or 2 have good GFR but other evidence of kidney damage. Persons in stage 3 CKD have moderately reduced GFR, less than 60 mL per minute per 1.73 m2. In general, persons in stage 3 are at risk for further loss of kidney function, although this risk is quite variable. Therefore, it is important to intervene and modify all possible risk factors to reduce this risk to the greatest extent possible. Persons in stage 4 CKD have a GFR less than 30 mL per minute per 1.73 m2. Studies suggest such individuals are at high risk for complications of chronic kidney disease, such as anemia and bone disease. Furthermore, cardiovascular complications are very high in persons with stage 4 CKD. Therefore, it is important to identify these persons in order to treat their complications of kidney disease and modify all possible cardiovascular risk factors. Finally, persons with stage 5 CKD have a GFR less than 15 mL per minute per 1.73 m2. This is typically in the threshold where persons are symptomatic and need to start on a renal replacement therapy, such as dialysis or kidney transplantation.
Stages of Chronic Kidney Disease
Jump to section:
- A Case
- 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