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ORIGINAL RESEARCH article

Front. Med.
Sec. Nephrology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1477343
This article is part of the Research Topic Renal Dysfunction in Cardiometabolic Disease: Implications of Inflammation and Oxidative Stress View all 3 articles

Difference between estimated glomerular filtration rate based on cystatin C versus creatinine and cardiovascular-kidney-metabolic health

Provisionally accepted
Xiaoyan Wu Xiaoyan Wu Wuming Hu Wuming Hu Jian Xu Jian Xu *Jiayi Shen Jiayi Shen Li Lin Li Lin Jingshuai Zhu Jingshuai Zhu Tiemin Wei Tiemin Wei *Lingchun Lv Lingchun Lv *
  • Department of Cardiology, Lishui Central Hospital, Lishui, China

The final, formatted version of the article will be published soon.

    Background: The difference between estimated glomerular filtration rate (eGFR) calculated from cystatin C and from creatinine (eGFRdiff) is a biomarker of kidney function impairment. The role of eGFRdiff in cardiovascular-kidney-metabolic (CKM) health and its impact on mortality in CKM syndrome patients has not been studied yet. Methods: This study included 3,622 participants from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2004. Weighted ordinal logistic regression explored the link between eGFRdiff and CKM health, while weighted Cox regression examined the relationship between eGFRdiff and mortality in CKM syndrome patients. Restricted cubic splines (RCS) analyzed the dose-response relationship. Results: The common odds ratio (cOR) per 10 mL/min/1.73m² increase in eGFRdiff was 0.86 [95% CI, 0.81 to 0.91]. Compared to midrange eGFRdiff, the cOR for negative and positive eGFRdiff were 1.88 [95% CI, 1.23 to 2.88] and 0.69 [95% CI, 0.58 to 0.83], respectively. Over a median follow-up of 201 months, 853 participants died from all causes, and 265 died from cardiovascular causes. The hazard ratios (HRs) per 10 mL/min/1.73m² increase in eGFRdiff were 0.88 [95% CI, 0.83 to 0.93] for all-cause mortality and 0.90 [95% CI, 0.81 to 1.00] for cardiovascular mortality. Compared to those with midrange eGFRdiff, participants with negative eGFRdiff had a 48% higher risk of all-cause mortality, while those with positive eGFRdiff had a 30% lower risk. No significant non-linear associations were found in these regressions. Conclusion: Our study found that eGFRdiff is associated to CKM health and stratified mortality risk in CKM syndrome patients.

    Keywords: cystatin C1, estimated glomerular filtration rate2, serum creatinine3, cardiovascular-kidney-metabolic4, NHANES5

    Received: 21 Aug 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Wu, Hu, Xu, Shen, Lin, Zhu, Wei and Lv. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jian Xu, Department of Cardiology, Lishui Central Hospital, Lishui, China
    Tiemin Wei, Department of Cardiology, Lishui Central Hospital, Lishui, China
    Lingchun Lv, Department of Cardiology, Lishui Central Hospital, Lishui, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.