Dual creatinine and cystatin C based eGFR measurements can help identify patient at higher health risk

Estrella et al 2025(JAMA): A Meta-Analysis of 821327 outpatient participants and nearly 39 639 hospitalized patients who had both creatinine and cystatin C based eGFR measurements were conducted. Participants were followed for an average of 11 years to evaluate long term outcomes. The analysis showed that approximately 11% of outpatients and 35% of hospitalized patients had cystatin C-based eGFR values that were at least 30% lower than creatinine-based estimates. Patients with this marked difference, faced significantly higher risks of all cause mortality, cardiovascular disease, heart failure, and progression to kidney failure requiring replacement therapy. The findings highlight the importance of using both creatinine and cystatin- C measurements to gain a more accurate picture of kidney function. Dual testing may help clinicians identify high-risk patients earlier in the disease course, allowing for intensified monitoring, preventive strategies, and timely therapeutic intervention, particularly in older adults and individuals with complex medical conditions.