Core IM | Internal Medicine Podcast #139 CKD Staging (Cr vs. Cystatin C, Albuminuria & more): Mind The Gap Segment
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Nov 8, 2023 Explore the pros and cons of using Cr or Cystatin C to assess eGFR in CKD staging. Learn about the limitations of creatinine as a biomarker for kidney function and the importance of considering glomerular filtration rate and albuminuria. Discover the implications of low GFR in patient care, the advantages of using cystatin C and measuring albuminuria, and the flaws of using creatinine in evaluating renal function.
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Dual CKD Staging Importance
- CKD staging now includes both GFR (G-stage) and albuminuria (A-stage) as independent risk factors.
- This dual staging helps better assess kidney function and guide clinical management.
Creatinine EGFR Has Wide Error
- Creatinine-based EGFR is an estimate and has a wide confidence interval, often inaccurate.
- The 95% confidence interval for a GFR of 60 ranges from 35 to 85, showing estimation flaws.
Creatinine Flaws in GFR Estimation
- Creatinine levels depend on skeletal muscle mass, leading to inaccurate GFR estimates.
- Creatinine secretion by tubules and drug interactions further distort serum levels and GFR calculations.