Discordant Results Between Creatinine- and Cystatin C-based Equations for Estimating GFR
Abstract
Introduction Discordant results between cystatin C and creatinine in estimating glomerular filtration rate (GFR) are an important medical issue. However, the equation that should be used when GFR estimates are discordant remains unclear. Methods This cross-sectional analysis included 15,485 participants with GFR measured by the clearance of an exogenous marker, serum creatinine, and cystatin C. We studied the proportion of discordant results defined as an absolute (> 15 ml/min per 1.73 m 2 ) or relative (> 20%) difference between creatinine-based estimated GFR (eGFR, eGFR crea ) and cystatin C–based eGFR (eGFR cys ) using different equations (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI], European Kidney Function Consortium [EKFC], and reexpressed Lund-Malmö [r-LMR]). We also researched for the best estimating equations to be used in subjects with concordant or discordant results to estimate measured GFR (mGFR). Results In the total cohort, the proportion of subjects with discordant results (absolute or relative) was larger for CKD-EPI (35.1 and 40.6%) than for EKFC (21.9 and 31.7%) or r-LMR (22.8 and 32.8%) equations. Among discrepant results, the proportion of eGFR cys < eGFR crea was significantly higher than the proportion of eGFR crea < eGFR cys for the CKD-EPI equations, whereas the occurrence of discrepancy was similar in the 2 discrepant groups for EKFC or r-LMR. For the EKFC and r-LMR equations, but not for the CKD-EPI, the equation combining creatinine and cystatin C was consistently the closest to the mGFR in the discrepant groups. Conclusion Based on the lower discrepancy proportion, better balance between eGFR crea and eGFR cys , and better concordance with mGFR, the EKFC, and r-LMR equations should be preferred over the CKD-EPI to estimate GFR.
Related
- Allometric equations for estimating tree volume and aboveground biomass of Acacia mangium Willd. on the Batéké Plateau, Republic of the Congo
- Altered Brain Extracellular Matrix Structure and Sex-Specific Learning/Memory Dysfunction in Mice Lacking the Functional Amyloid Cystatin-Related Epididymal Spermatogenic (CRES)
- Serum Cystatin 4 combined with routine clinical laboratory indicators: A support vector machine diagnostic model for early screening of gastrointestinal tumors
- Altered Brain Extracellular Matrix Structure and Sex-Specific Learning/Memory Dysfunction in Mice Lacking the Functional Amyloid Cystatin-Related Epididymal Spermatogenic
- Phylogenetic parallelograms: visual comparison of discordant phylogenetic trees
BibTeX
@article{delanaye2026discordant,
title = {{Discordant Results Between Creatinine- and Cystatin C-based Equations for Estimating GFR}},
author = {Pierre Delanaye and Martin Flamant and Emmanuelle Vidal-Petiot and Jonas Björk and Ulf Nyman and Anders Grubb and Stephan J.L. Bakker and Martin de Borst and Marco van Londen and Laurence Derain-Dubourg and Andrew Rule and Björn Eriksen and Toralf Melsom and Per-Ola Sundin and Natalie Ebert and Elke Schaeffner and Magnus Hansson and Karin Littmann and Anders Larsson and Thomas Stehlé and Etienne Cavalier and Justine Bukabau and Ernest Sumaili and Eric Yayo and Christophe Mariat and Olivier Moranne and Anders Christensson and Antoine Lanot and Hans Pottel},
journal = {Kidney International Reports},
year = {2026},
month = sep,
doi = {10.1016/j.ekir.2025.01.030},
url = {https://hal.science/hal-05746220v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Discordant Results Between Creatinine- and Cystatin C-based Equations for Estimating GFR
AU - Pierre Delanaye
AU - Martin Flamant
AU - Emmanuelle Vidal-Petiot
AU - Jonas Björk
AU - Ulf Nyman
AU - Anders Grubb
AU - Stephan J.L. Bakker
AU - Martin de Borst
AU - Marco van Londen
AU - Laurence Derain-Dubourg
AU - Andrew Rule
AU - Björn Eriksen
AU - Toralf Melsom
AU - Per-Ola Sundin
AU - Natalie Ebert
AU - Elke Schaeffner
AU - Magnus Hansson
AU - Karin Littmann
AU - Anders Larsson
AU - Thomas Stehlé
AU - Etienne Cavalier
AU - Justine Bukabau
AU - Ernest Sumaili
AU - Eric Yayo
AU - Christophe Mariat
AU - Olivier Moranne
AU - Anders Christensson
AU - Antoine Lanot
AU - Hans Pottel
PY - 2026
DA - 2026/09/11
JO - Kidney International Reports
DO - 10.1016/j.ekir.2025.01.030
UR - https://hal.science/hal-05746220v1
AB - Introduction Discordant results between cystatin C and creatinine in estimating glomerular filtration rate (GFR) are an important medical issue. However, the equation that should be used when GFR estimates are discordant remains unclear. Methods This cross-sectional analysis included 15,485 participants with GFR measured by the clearance of an exogenous marker, serum creatinine, and cystatin C. We studied the proportion of discordant results defined as an absolute (> 15 ml/min per 1.73 m 2 ) or relative (> 20%) difference between creatinine-based estimated GFR (eGFR, eGFR crea ) and cystatin C–based eGFR (eGFR cys ) using different equations (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI], European Kidney Function Consortium [EKFC], and reexpressed Lund-Malmö [r-LMR]). We also researched for the best estimating equations to be used in subjects with concordant or discordant results to estimate measured GFR (mGFR). Results In the total cohort, the proportion of subjects with discordant results (absolute or relative) was larger for CKD-EPI (35.1 and 40.6%) than for EKFC (21.9 and 31.7%) or r-LMR (22.8 and 32.8%) equations. Among discrepant results, the proportion of eGFR cys < eGFR crea was significantly higher than the proportion of eGFR crea < eGFR cys for the CKD-EPI equations, whereas the occurrence of discrepancy was similar in the 2 discrepant groups for EKFC or r-LMR. For the EKFC and r-LMR equations, but not for the CKD-EPI, the equation combining creatinine and cystatin C was consistently the closest to the mGFR in the discrepant groups. Conclusion Based on the lower discrepancy proportion, better balance between eGFR crea and eGFR cys , and better concordance with mGFR, the EKFC, and r-LMR equations should be preferred over the CKD-EPI to estimate GFR.
SN - 2468-0249
ER -