cystatin c– and creatinine-based estimated glomerular filtration rate, vascular disease, and...
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![Page 1: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/1.jpg)
Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and
Mortality in Persons With Diabetes in the U.S.
Featured Article:
Ching-Wei Tsai, Morgan E. Grams, Lesley A. Inker, Josef Coresh, and Elizabeth Selvin
Diabetes Care Volume 37: 1002-1008
April, 2014
![Page 2: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/2.jpg)
STUDY OBJECTIVE
• Serum cystatin C is an alternative to serum creatinine for estimating glomerular filtration rate (GFR)
• Performance of GFR estimated using cystatin C (eGFRcys) was compared with that using creatinine (eGFRcr) for the identification of reduced kidney function and its association with diabetes complications
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 3: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/3.jpg)
STUDY DESIGN AND METHODS
• Data were analyzed from adult participants from the 1999–2002 National Health and Nutrition Examination Survey with available cystatin C
• Kidney function was dichotomized as preserved or reduced using the 2012 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) cystatin C and the 2009 CKD-EPI creatinine equations
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 4: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/4.jpg)
RESULTS
• Among 778 diabetes patients, the prevalence of reduced kidney function was 16.5% using eGFRcr and 22.0% using eGFRcys
• More people with diabetes were reclassified from preserved kidney function by eGFRcr to reduced kidney function by eGFRcys than people without diabetes
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 5: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/5.jpg)
RESULTS
• Associations between lower eGFR and higher prevalence of albuminuria, retinopathy, peripheral arterial disease, and coronary artery disease were robust regardless of filtration marker
• Risk of all-cause mortality increased with lower eGFRcr and eGFRcys
• Only lower eGFRcys was significantly associated with cardiovascular mortality
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 6: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/6.jpg)
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 7: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/7.jpg)
CONCLUSIONS
• More people with diabetes had reduced kidney function by eGFRcys than by eGFRcr
• Lower eGFRcys was strongly associated with diabetes complications
• Whether eGFRcys is superior to eGFRcr in approximating true kidney function in a diabetic population requires additional study
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 8: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/8.jpg)
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 9: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/9.jpg)
Tsai et al. Diabetes Care 2014;37:1002-1008
![Page 10: Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate, Vascular Disease, and Mortality in Persons With Diabetes in the U.S. Featured Article:](https://reader035.vdocuments.mx/reader035/viewer/2022070407/56649e235503460f94b1177b/html5/thumbnails/10.jpg)
Tsai et al. Diabetes Care 2014;37:1002-1008