| Title: | Comparison of creatinine-, cystatin C-, and combined creatinine–cystatin C-based equations for estimating glomerular filtration rate : a real-world analysis in patients with chronic kidney disease |
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| Authors: | ID Osredkar, Joško (Author)
ID Klemenčič, Iza (Author)
ID Kumer, Kristina (Author)
ID Pajek, Jernej (Author)
ID Knap, Bojan (Author) |
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| Files: |  PDF - Presentation file, download (1,28 MB)
MD5: 18481FD6F103EA53A6C7D7E80148F742
 URL - Source URL, visit https://www.mdpi.com/1422-0067/27/1/364
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | The estimated glomerular filtration rate (eGFR) is a cornerstone of kidney function assessment. Widely used Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations based on serum creatinine (eGFRcr), cystatin C (eGFRcysC), or both (eGFRcr-cysC) are influenced by non-glomerular filtration rate (GFR) factors, and their performance may vary across clinical contexts. We retrospectively analyzed 435 adult patients with simultaneous serum creatinine and cystatin C measurements. eGFR was calculated using CKD-EPI 2021 (creatinine), CKD-EPI 2012 (cystatin C), and CKD-EPI 2021 (combined) equations. Patients were classified into Kidney Disease: Improving Global Outcomes (KDIGO) GFR categories (G1–G5), and discrepancies between equations were identified. 44 patients (10.1%) showed discordant GFR categorization across all three equations and underwent detailed clinical assessment. 16 of the 44 discordant cases had clinically confirmed chronic kidney disease (CKD). The combined equation aligned with the clinical diagnosis in all CKD cases. eGFRcr overestimated kidney function in 10/16 patients, while eGFRcysC produced lower values in 8/16, consistent with early CKD but potentially influenced by inflammation or obesity. Reclassification occurred in 9/16 patients when switching from eGFRcr to eGFRcr-cysC, including four who shifted from G2 to G3a–G4. A significant difference was observed between eGFRcr and eGFRcr-cysC (p < 0.05). The combined CKD-EPI equation demonstrated the best clinical concordance, supporting its broader use when diagnostic accuracy is essential. |
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| Keywords: | chronic kidney disease, glomerular filtration rate, eGFR, CKD-EPI, creatinine, cystatin C, GFR classification, diagnostic accuracy |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2026 |
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| Number of pages: | 12 str. |
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| Numbering: | Vol. 27, iss. 1, [article no.] 364 |
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| PID: | 20.500.12556/DiRROS-28030  |
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| UDC: | 616-07:616.61-008.6 |
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| ISSN on article: | 1422-0067 |
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| DOI: | 10.3390/ijms27010364 |
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| COBISS.SI-ID: | 264239363 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 12. 1. 2026;
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| Publication date in DiRROS: | 06.03.2026 |
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| Views: | 46 |
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| Downloads: | 35 |
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