Annals On Call Podcast
The Value of Cystatin C Measurement
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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Quick takeaways
- Estimating GFR in the elderly solely based on creatinine may not accurately predict adverse outcomes related to end-stage renal disease or death, leading to controversy over distinguishing normal kidney function decline from disease progression.
- Incorporating cystatin C alongside creatinine for GFR estimation provides a more accurate measure of kidney function by accounting for muscle mass variability, improving prediction of adverse outcomes and aiding in the differentiation of true kidney disease cases in patients with fluctuating muscle mass conditions.
Deep dives
Challenges with Estimated GFR in Elderly Patients
When estimating GFR solely based on creatinine in individuals over 65, it becomes less predictive of adverse outcomes related to end-stage renal disease or death compared to younger individuals. This raises a controversy around whether CKD Stage 3A truly signifies kidney disease in the elderly, leading to concerns about differentiating normal physiological kidney function decline due to aging from accelerated deterioration caused by specific kidney diseases.
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