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Association of cystatin C with adverse outcomes Madero M; Sarnak MJCurr Opin Nephrol Hypertens 2009[May]; 18 (3): 258-63PURPOSE OF REVIEW: To discuss recent studies which have evaluated determinants of cystatin C and to focus on the relationship of cystatin C with mortality, cardiovascular disease (CVD), and noncardiovascular outcomes. RECENT FINDINGS: In the Chronic Kidney Disease Epidemiology Study cystatin C was associated with demographic characteristics independent of measured glomerular filtration rate (GFR), although this was to a smaller extent than creatinine. In patients with established chronic kidney disease (CKD), cystatin C was strongly and inversely correlated with measured GFR, suggesting that although cystatin C may have other determinants, it is primarily a measure of kidney function. Several cohort studies, particularly in older adults, have now demonstrated that cystatin C is linearly associated with mortality, CVD and non-CVD outcomes, whereas creatinine is primarily associated with risk in individuals with more advanced kidney disease. A recent study has also shown that changes in kidney function as ascertained by cystatin C, even within the relatively normal range, are associated with subsequent CVD and all-cause mortality among older adults. SUMMARY: Cystatin C appears to capture an association of mild kidney disease with increased risk of mortality, CVD and non-CVD outcomes. Future studies should evaluate whether cystatin C can improve medical decision-making and lead to favorable patient outcomes.|Animals[MESH]|Cardiovascular Diseases/epidemiology/physiopathology[MESH]|Cystatin C/metabolism/*physiology[MESH]|Glomerular Filtration Rate[MESH]|Humans[MESH]|Kidney Failure, Chronic/complications/mortality/*physiopathology[MESH]|Risk Factors[MESH] |
