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| 001 | 305711 | ||
| 005 | 20251203142640.0 | ||
| 024 | 7 | _ | |a 10.1001/jama.2025.17578 |2 doi |
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| 100 | 1 | _ | |a Estrella, Michelle M |b 0 |
| 245 | _ | _ | |a Discordance in Creatinine- and Cystatin C-Based eGFR and Clinical Outcomes: A Meta-Analysis. |
| 260 | _ | _ | |a Chicago, Ill. |c 2025 |b American Medical Association |
| 336 | 7 | _ | |a article |2 DRIVER |
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| 336 | 7 | _ | |a Journal Article |b journal |m journal |0 PUB:(DE-HGF)16 |s 1764768324_1331671 |2 PUB:(DE-HGF) |
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| 336 | 7 | _ | |a Journal Article |0 0 |2 EndNote |
| 500 | _ | _ | |a 2025 Dec 2;334(21):1915-1926 |
| 520 | _ | _ | |a Estimated glomerular filtration rates (eGFRs) can differ according to whether creatinine or cystatin C is used for the eGFR calculation, but the prevalence and importance of these differences remain unclear.To evaluate the prevalence of a discordance between cystatin C-based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcr), identify characteristics associated with greater discordance, and evaluate associations of discordance with adverse outcomes.Participants in the Chronic Kidney Disease Prognosis Consortium (CKD-PC).Participants with concurrent cystatin C and creatinine measurements and clinical outcome measurement.Between April 2024 and August 2025, data were synthesized using individual-level meta-analysis.The primary independent measurement was a large negative eGFR difference (eGFRdiff), defined as an eGFRcys that was at least 30% lower than eGFRcr. Secondary (dependent) outcomes included all-cause and cardiovascular mortality, atherosclerotic cardiovascular disease, heart failure, and kidney failure with replacement therapy.A total of 821 327 individuals from 23 outpatient cohorts (mean [SD] age, 59 [12] years; 48% female; 13.5% with diabetes; 40% with hypertension) and 39 639 individuals from 2 inpatient cohorts (mean [SD] age, 67 [16] years; 31% female; 30% with diabetes; 72% with hypertension) were included. Among outpatient participants, 11% had a large negative eGFRdiff (range, 3%-50%). Among inpatients, 35% had a large negative eGFRdiff. Among outpatient participants, at a mean (SD) follow-up of 11 (4) years, a large negative eGFRdiff, compared with an eGFRdiff between -30% and 30%, was associated with higher rates of all-cause mortality (28.4 vs 16.8 per 1000 person-years [PY]; hazard ratio [HR], 1.69 [95% CI, 1.57-1.82]), cardiovascular mortality (6.1 vs 3.8 per 1000 PY; HR, 1.61 [95% CI, 1.48-1.76]), atherosclerotic cardiovascular disease (13.3 vs 9.8 per 1000 PY; HR, 1.35 [95% CI, 1.27-1.44]), heart failure (13.2 vs 8.6 per 1000 PY; HR, 1.54 [95% CI, 1.40-1.68]), and kidney failure with replacement therapy (2.7 vs 2.1 per 1000 PY; HR, 1.29 [95% CI, 1.13-1.47]).In the CKD-PC, 11% of outpatient participants and 35% of hospitalized patients had an eGFRcys that was at least 30% lower than their eGFRcr. In the outpatient setting, presence of eGFRcys at least 30% lower than eGFRcr was associated with significantly higher rates of all-cause mortality, cardiovascular events, and kidney failure. |
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| 700 | 1 | _ | |a Ballew, Shoshana H |b 1 |
| 700 | 1 | _ | |a Sang, Yingying |b 2 |
| 700 | 1 | _ | |a Grams, Morgan E |b 3 |
| 700 | 1 | _ | |a Coresh, Josef |b 4 |
| 700 | 1 | _ | |a Surapaneni, Aditya |b 5 |
| 700 | 1 | _ | |a Alencar de Pinho, Natalia |b 6 |
| 700 | 1 | _ | |a Ärnlöv, Johan |b 7 |
| 700 | 1 | _ | |a Brenner, Hermann |0 P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2 |b 8 |u dkfz |
| 700 | 1 | _ | |a Carrero, Juan-Jesus |b 9 |
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| 700 | 1 | _ | |a Cohen, Debbie L |b 11 |
| 700 | 1 | _ | |a Cushman, Mary |b 12 |
| 700 | 1 | _ | |a Gansevoort, Ron T |b 13 |
| 700 | 1 | _ | |a Hwang, Shih-Jen |b 14 |
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| 700 | 1 | _ | |a Polkinghorne, Kevan R |b 20 |
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| 700 | 1 | _ | |a Wheeler, David C |b 23 |
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| 700 | 1 | _ | |a Investigators, Chronic Kidney Disease Prognosis Consortium |b 27 |
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| 700 | 1 | _ | |a Chen, Teresa K |b 29 |e Contributor |
| 700 | 1 | _ | |a Sang, Yingying |b 30 |e Contributor |
| 700 | 1 | _ | |a Grams, Morgan E |b 31 |e Contributor |
| 700 | 1 | _ | |a Coresh, Josef |b 32 |e Contributor |
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