title: Cystatin C as a biomarker for estimating glomerular filtration rate.
abstract: OBJECTIVE
  Glomerular filtration rate (GFR) is rarely measured in clinical practice because of the complexity of the measurement. As such, kidney function is typically estimated using validated study equations, which use readily available data including age, sex, race, and serum creatinine as filtration marker. Contemporary research suggests that cystatin C may be an improved alternative to creatinine for inclusion in GFR estimating equations. The purpose of this article is to evaluate the benefits and limitations of using cystatin C as a biomarker of filtration.
  
  
  RESULTS
  Cystatin C has fewer non-GFR determinants, when compared with serum creatinine. Use of serum cystatin C avoids the limitations related to both diet and muscle mass that affect serum creatinine. Cystatin C may be more accurate than serum creatinine in estimating GFR, and is more strongly associated with all-cause mortality and cardiovascular events.
  
  
  CONCLUSIONS
  Cystatin C has some advantages over serum creatinine in estimating GFR. The use of cystatin C as a confirmatory biomarker in deciding medication dosages or as a confirmatory test in patients with an uncertain diagnosis of chronic kidney disease may be beneficial.
authors.affiliation: aDepartment of Community Health Sciences bSection of Nephrology, Department of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Ferguson
authors.forename: Paul
authors.initials: P
authors.lastname: Komenda
authors.forename: Navdeep
authors.initials: N
authors.lastname: Tangri
mesh_terms: D015415:Biomarkers / Q000097:blood*; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D003404:Creatinine