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Chronic kidney disease, cardiovascular risk markers and total mortality in older men: cystatin C versus creatinine

2019; BMJ; Volume: 73; Issue: 7 Linguagem: Inglês

10.1136/jech-2018-211719

1470-2738

Shahrzad Zonoozi, Sheena E Ramsay, Olia Papacosta, Lucy Lennon, Elizabeth A. Ellins, Julian Halcox, Peter H. Whincup, S. Goya Wannamethee,

Blood Pressure and Hypertension Studies

It remains uncertain whether cystatin C is a superior marker of renal function than creatinine in older adults. We have investigated the association between estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations based on creatinine (CKD-EPIcr) and cystatin C (CKD-EPIcys), and cardiovascular risk markers and mortality in older adults.This is a cross-sectional and prospective study of 1639 British men aged 71-92 years followed up for an average of 5 years for mortality. Cox survival model and receiving operating characteristic analysis were used to assess the associations.The prevalence of chronic kidney disease (CKD) was similar using the two CKD-EPI equations, although cystatin C reclassified 43.9% of those with stage 3a CKD (eGFR 45-59 mL/min/1.732, moderate damage) to no CKD. However, CKD stages assessed using both CKD-EPIcr and CKD-EPIcys were significantly associated with vascular risk markers and with all-cause and cardiovascular disease mortality. In all men with CKD (eGFR 70 years. Our data do not support the routine use of CKD-EPIcys for identifying CKD in the elderly British male population.