Association of Intraindividual Difference in Estimated Glomerular Filtration Rate by Creatinine vs Cystatin C and End-stage Kidney Disease and Mortality

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Abstract
The burden of chronic kidney disease (CKD) in the US is substantial, with more than 130 000 persons progressing to end-stage kidney disease (ESKD) each year.1 Estimated glomerular filtration rate (eGFR) is crucial for staging and risk-stratifying persons with CKD, as lower eGFR has an independent, graded association with higher risk for ESKD and mortality.2-4 Creatinine and cystatin C are biomarkers used to determine eGFR. However, cystatin C–based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcr) measured in the same individual may be highly discrepant.5,6 Currently, there is no guidance for CKD risk stratification when eGFRcys and eGFRcr are substantially different, and the clinical implications of these differences are unclear.

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