Factors other than glomerular filtration rate affect serum cystatin C levels

Lesley A. Stevens, Christopher H. Schmid, Tom Greene, Liang Li, Gerald J. Beck, Marshall M. Joffe, Marc Froissart, John W. Kusek, Yaping Zhang, Josef Coresh, Andrew S. Levey

Research output: Contribution to journalArticlepeer-review


Cystatin C is an endogenous glomerular filtration marker hence its serum level is affected by the glomerular filtration rate (GFR). To study what other factors might affect it blood level we performed a cross-sectional analysis of 3418 patients which included a pooled dataset of clinical trial participants and a clinical population with chronic kidney disease. The serum cystatin C and creatinine levels were related to clinical and biochemical parameters and errors-in-variables models were used to account for errors in GFR measurements. The GFR was measured as the urinary clearance of 125I-iothalamate and 51Cr-EDTA. Cystatin C was determined at a single laboratory while creatinine was standardized to reference methods and these were 2.1+/-1.1 mg/dL and 1.8+/-0.8 mg/L, respectively. After adjustment for GFR, cystatin C was 4.3% lower for every 20 years of age, 9.2% lower for female gender but only 1.9% lower in blacks. Diabetes was associated with 8.5% higher levels of cystatin C and 3.9% lower levels of creatinine. Higher C-reactive protein and white blood cell count and lower serum albumin were associated with higher levels of cystatin C and lower levels of creatinine. Adjustment for age, gender and race had a greater effect on the association of factors with creatinine than cystatin C. Hence, we found that cystatin C is affected by factors other than GFR which should be considered when the GFR is estimated using serum levels of cystatin C.

Original languageEnglish (US)
Pages (from-to)652-660
Number of pages9
JournalKidney international
Issue number6
StatePublished - 2009


  • Creatinine
  • Cystatin
  • Glomerular filtration rate generation

ASJC Scopus subject areas

  • Nephrology


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