title: Cystatin C as a predictor of mortality and cardiovascular events in a population with chronic kidney disease.
abstract: Background. We examine whether cystatin C, a surrogate marker of renal function, could identify patients with chronic kidney disease (CKD) with an increased risk of renal disease progression, death, or cardiovascular events. Methods. Data were obtained for 180 patients, with a diagnosis of chronic renal failure based on serum creatinine estimated glomerular filtration rate (eGFRcreat) <90 mL/min/1.73 m(2). This population was grouped in tertiles according to cystatin C and creatinine values at baseline. Cardiovascular events and overall mortality were estimated for each tertile. Predictors of overall mortality and for the development of renal disease progression were analyzed. Results. The median age was 75 years (interquartile range 69-82) and the median eGFRcreat 38 mL/min m(2) (interquartile range 33-49). Overall mortality was lower on the first and on the second tertiles of cystatin C than on the third one (HR = 0.060; 95% CI: 0.008-0.447 and HR = 0.094; 95% CI: 0.022-0.406, resp.). Deaths related to the creatinine tertiles followed the same pattern, but differences were not as large. Cardiovascular mortality was lower on the second than on the third cystatin C tertile (HR = 0.198; 95% CI: 0.040-0.987), but it did not show differences on the first and the second creatinine tertiles compared with the third one (HR = 0.126; 95% CI: 0.013-1.265 and HR = 0.403; 95% CI: 0.093-1.740). The only independent predictors of mortality during followup were baseline cystatin C (OR = 0.100; 95% CI: 0.021-0.463) and baseline uric acid (OR = 1.377; 95% CI: 1.070-1.773). Conclusion. Cystatin C may be an alternative to creatinine for detecting a high risk of death and cardiovascular events in a population with CKD.
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Vigil
authors.affiliation: Department of Medical Specialties, Psychology and Applied Pedagogy, Universidad European de Madrid, Villaviciosa de Odon, 28670 Madrid, Spain.
authors.forename: Emilia
authors.initials: E
authors.lastname: Condés
authors.affiliation: Hypertension Unit, Department of Internal Medicine, Hospital Universitario de Mostoles, Móstoles, 28935 Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Vigil
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Gallar
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Aniana
authors.initials: A
authors.lastname: Oliet
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Olimpia
authors.identifier: 0000-0001-5122-3018
authors.initials: O
authors.lastname: Ortega
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodriguez
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Milagros
authors.initials: M
authors.lastname: Ortiz
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Herrero
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mon
authors.affiliation: Department of Nephrology, Nephrology Service, Hospital Universitario Severo Ochoa, Avenida. Orellana s/n, Leganés, 28911 Madrid, Spain.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Cobo
authors.affiliation: Department of Biochemistry, Hospital Universitario Severo Ochoa, Leganes, 28911 Madrid, Spain.
authors.forename: Juana
authors.initials: J
authors.lastname: Jimenez