Annals On Call Podcast The Value of Cystatin C Measurement
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May 20, 2024 
Dr. Joel Topf discusses the significance of cystatin C in estimating GFR, especially in older individuals and those with varying muscle mass. He explores the challenges of predicting kidney disease outcomes in the elderly and the importance of accurate GFR calculation. The podcast delves into incorporating advanced testing methods like cystatin C and creatinine for predicting outcomes and enhancing eGFR estimation for personalized risk assessment.
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Creatinine eGFR Limits in Elderly
- Creatinine-based eGFR is less predictive of kidney disease outcomes in people over 65 due to normal age-related kidney decline.
- This causes overdiagnosis of chronic kidney disease (CKD) in the elderly, confusing normal aging with true disease.
Muscle Mass Distorts Creatinine eGFR
- Muscle mass variations cause inaccuracies in creatinine-based eGFR estimates.
- Frail, low muscle mass patients can appear to have high eGFR despite worse outcomes, causing misleading results.
Cystatin C as Kidney Marker
- Cystatin C is produced by all nucleated cells and cleared by kidneys, making it a useful kidney function marker.
- It correlates closely to creatinine levels but is less influenced by muscle mass, providing a more reliable GFR estimate.