The cystatin C test is a blood test that measures kidney function by detecting levels of cystatin C, a small protein produced by all cells in your body. Unlike creatinine tests, cystatin C is not significantly affected by muscle mass, age, sex, or diet, making it more accurate for detecting early kidney disease, especially in elderly patients, diabetics, and those with unusual muscle mass.
💡 What You Need to Know Right Away
- High diagnostic accuracy: Cystatin C detects chronic kidney disease with 88% sensitivity and 90% specificity across 18,000 participants.[Evidence: A][1]
- Predicts cardiovascular risk: Elevated cystatin C is associated with a 37% increased risk of heart attack and 47% increased risk of major cardiovascular events.[Evidence: B][7]
- Superior to creatinine alone: Combined creatinine-cystatin C equations achieve 94.9% accuracy (P30) compared to 90% for creatinine alone.[Evidence: A][11]
- Recommended by KDIGO 2024: Current clinical guidelines give a 1B recommendation for combined eGFR testing using both creatinine and cystatin C when available.[Evidence: D][5]
If you have been told your kidney function may be declining, or if you are managing diabetes or heart disease, you may have heard about the cystatin C test. It is common to feel uncertain about which kidney test provides the most accurate picture of your health.
The cystatin C test has gained significant clinical adoption in recent years. Over 60% of laboratories now incorporate cystatin C testing, with a 25% rise in adoption during 2023 alone. The March 2024 KDIGO clinical practice guideline update reinforced its value as a key biomarker for chronic kidney disease assessment.
In this guide, you will learn exactly what the cystatin C test measures, how it compares to traditional creatinine testing, what your results mean, and who benefits most from this advanced kidney function assessment. Every claim is supported by peer-reviewed research from meta-analyses and clinical studies.
❓ Quick Answers
What is a cystatin C test used for?
The cystatin C test measures kidney function by detecting how well your kidneys filter cystatin C protein from your blood. It is primarily used to estimate glomerular filtration rate (eGFR), diagnose chronic kidney disease, and monitor kidney function in people with diabetes, cardiovascular disease, or conditions where creatinine may be unreliable.[Evidence: A][1]
What is a normal cystatin C level?
Normal cystatin C levels for adults range from 0.58 to 1.04 mg/L using IFCC-standardized assays. Women typically range from 0.58-1.00 mg/L, while men range from 0.62-1.04 mg/L. For adults over 60, normal ranges are slightly higher at 0.74-1.14 mg/L due to age-related kidney function changes.[Evidence: A][15]
Is cystatin C more accurate than creatinine?
Research indicates cystatin C is more accurate than creatinine in many populations. A meta-analysis of 35 studies with 23,667 participants found cystatin C-based formulas have 4.84 mL/min/1.73m² lower bias than creatinine. Combined equations achieve 7.50% higher accuracy than creatinine alone.[Evidence: A][15]
Do you need to fast for a cystatin C test?
Fasting is generally not required for a cystatin C test. Unlike some blood tests, cystatin C levels are not significantly affected by food intake. However, some laboratories may request overnight fasting as a standard protocol. Always follow your healthcare provider's specific instructions before the test.
Can cystatin C predict heart disease?
Yes, elevated cystatin C predicts cardiovascular outcomes independent of kidney function. The LIPID study found cystatin C was associated with a hazard ratio of 1.37 for heart attack and 1.47 for major cardiovascular events over 6 years. These associations persisted at 16-year follow-up.[Evidence: B][7]
What is cystatin C eGFR?
Cystatin C eGFR is an estimated glomerular filtration rate calculated using cystatin C blood levels instead of or in addition to creatinine. The CKD-EPI 2021 equation provides race-free eGFR calculations. Combined creatinine-cystatin C equations achieve P30 accuracy of 90.5-94.9% across diverse populations.[Evidence: A][4]
Who should get a cystatin C test?
KDIGO 2024 guidelines recommend cystatin C testing for individuals with muscle wasting, special diets, severe illness, or when creatinine results are uncertain. It is particularly valuable for elderly patients, bodybuilders with high muscle mass, diabetics monitoring nephropathy, and patients requiring accurate medication dosing.[Evidence: D][5]
Cystatin C
Test Guide
Explore the next generation of kidney function testing. Learn why this small protein is changing how doctors monitor renal health.
🔬 How Does the Cystatin C Test Work?
Understanding how the cystatin C test works helps explain why it has become an increasingly important tool in kidney assessment. Think of cystatin C as a molecular speedometer for your kidneys. Just as a speedometer measures how fast a car is moving, cystatin C levels reveal how efficiently your kidneys are filtering your blood.
Cystatin C is a small protein (13 kilodaltons) produced at a constant rate by virtually all nucleated cells in your body. Because of its small size, cystatin C passes freely through the glomeruli, the tiny filtering units in your kidneys. Healthy kidneys then reabsorb and break down nearly all of this protein in the tubules.
When kidney function declines, the glomeruli become less efficient at filtering. Like a backed-up drain, cystatin C accumulates in the blood because the kidneys cannot process it as quickly. Higher blood levels indicate reduced kidney filtration capacity.[Evidence: A][1]
Why Cystatin C Differs from Creatinine
Traditional creatinine testing has a significant limitation: creatinine production depends heavily on muscle mass. An elderly person with low muscle mass may have "normal" creatinine despite impaired kidney function. Conversely, a bodybuilder may have elevated creatinine with perfectly healthy kidneys.
Cystatin C production is independent of muscle mass, age, sex, and diet. A meta-analysis of 25 studies encompassing 18,000 participants demonstrated pooled sensitivity of 88% (95% CI: 85-91%) and specificity of 90% (95% CI: 87-92%) for detecting chronic kidney disease.[Evidence: A][1]
The Science of eGFR Calculation
Estimated glomerular filtration rate (eGFR) translates cystatin C levels into a clinically meaningful number representing kidney function. The CKD-EPI 2021 equation developed by Inker and colleagues provides race-free calculations achieving P30 accuracy of 90.5% to 90.8% across diverse populations.[Evidence: A][4]
Combined creatinine-cystatin C equations demonstrate even better performance. The eGFR-C study found the combined equation achieved P30 accuracy of 94.9%, compared to 95% for cystatin C alone and 90% for creatinine alone. Importantly, these results were consistent across age, gender, diabetes status, BMI, and ethnicity.[Evidence: A][11]
The EKFC 2023 equation further refined cystatin C-based eGFR calculation, eliminating the need for race and sex variables while maintaining improved accuracy compared to commonly used equations across European, US, and African cohorts.[Evidence: A][10]
📊 Test Procedure and Normal Ranges
How the Test is Performed
The cystatin C test requires a simple blood draw from a vein in your arm. The procedure takes approximately 5-10 minutes. Blood samples are analyzed using immunoassay techniques, typically immunoturbidimetric or immunonephelometric methods calibrated to the IFCC ERM-DA471 international standard.
Results are usually available within 1-2 days. Most modern laboratories report both the raw cystatin C value and the calculated eGFR using standardized equations.
Normal Ranges and Interpretation
| Population | Normal Range (mg/L) | Notes |
|---|---|---|
| Adults (general) | 0.58-1.04 | IFCC-standardized assays |
| Women | 0.58-1.00 | Slightly lower upper limit |
| Men | 0.62-1.04 | Slightly higher lower limit |
| Adults ≥60 years | 0.74-1.14 | Higher due to age-related GFR decline |
eGFR Calculation and CKD Staging
| eGFR (mL/min/1.73m²) | CKD Stage | Kidney Function | Clinical Significance |
|---|---|---|---|
| ≥90 | G1 | Normal or high | May have other signs of kidney damage |
| 60-89 | G2 | Mildly decreased | Monitor if other risk factors present |
| 45-59 | G3a | Mildly-moderately decreased | Medicare coverage criteria met[5] |
| 30-44 | G3b | Moderately-severely decreased | Increased cardiovascular risk |
| 15-29 | G4 | Severely decreased | Prepare for kidney replacement therapy |
| <15 | G5 | Kidney failure | Dialysis or transplant needed |
Combined creatinine-cystatin C equations provide the most accurate eGFR classification. Research across 6,174 Swedish adults with measured iohexol GFR confirmed that combined equations achieved P30 accuracy close to 90% and performed consistently across cardiovascular disease, liver disease, diabetes, and cancer subgroups.[Evidence: A][16]
⚠️ Risks, Limitations, and Important Considerations
⚠️ Important Safety Information
- Cystatin C levels may be affected by thyroid dysfunction. Hyperthyroidism can falsely elevate levels, while hypothyroidism may lower them.
- High-dose corticosteroid therapy may affect cystatin C accuracy and should be reported to your healthcare provider.
- This test measures kidney function markers but cannot diagnose the underlying cause of kidney disease. Additional testing may be required.
- Results should always be interpreted by a qualified healthcare professional in the context of your complete clinical picture.
Factors That May Affect Results
While cystatin C is more consistent than creatinine across many variables, several conditions may influence results:
- Thyroid disorders: Both hyperthyroidism and hypothyroidism can affect cystatin C production rates
- High-dose corticosteroids: May influence cystatin C levels independent of kidney function
- Obesity: Some studies suggest higher cystatin C in obese individuals, though combined equations remain accurate[12]
- Inflammation: Severe inflammatory states may transiently affect levels
- Certain malignancies: Some cancers may influence cystatin C production
Test Limitations
The KDIGO 2024 guidelines acknowledge that while cystatin C improves GFR estimation accuracy, it should be used as part of comprehensive kidney assessment rather than as a sole diagnostic marker.[Evidence: D][5]
When to Consult Your Healthcare Provider
- If your cystatin C or eGFR results are abnormal or unexpected
- If you have symptoms such as decreased urination, swelling, fatigue, or foamy urine
- If you take medications that require kidney-based dosing adjustments
- If you are managing diabetes, hypertension, or cardiovascular disease
🥗 Practical Applications of Cystatin C Testing
Clinical Scenarios Where Cystatin C Excels
Understanding when cystatin C testing provides the greatest clinical value helps patients and healthcare providers make informed decisions:
1. Medication Dosing Accuracy
Accurate GFR estimation is critical for medications eliminated by the kidneys. A 2024 review in Kidney360 found that the CKD-EPI cystatin C formula had the lowest mean absolute percentage error for carboplatin chemotherapy dosing, demonstrating its importance in oncology settings where precise dosing affects both efficacy and toxicity.[Evidence: B][8]
2. Special Populations
Systematic review of 26 studies across 8 clinical populations confirmed that combined creatinine-cystatin C equations provide greater accuracy in:
- Cancer patients undergoing chemotherapy
- HIV-positive individuals
- Patients with obesity
- Individuals with liver cirrhosis[Evidence: A][12]
3. Liver Cirrhosis Assessment
In patients with liver cirrhosis, creatinine often overestimates true GFR due to reduced muscle mass and hepatic creatinine synthesis. A meta-analysis of 25 studies with 4,565 cirrhosis patients found that combined creatinine-cystatin C equations were least biased, making cystatin C valuable for pre-transplant assessment.[Evidence: A][14]
How Often Should You Be Tested?
Testing frequency depends on your clinical situation:
- Baseline assessment: Once when creatinine results are uncertain or in high-risk populations
- CKD monitoring: Every 3-12 months depending on stage and progression risk
- Acute illness: As clinically indicated to assess kidney injury
- Pre-surgical evaluation: When accurate GFR is needed for medication dosing
Cost and Accessibility
The cystatin C test typically costs between $99-$159 at direct-to-consumer laboratories. Medicare coverage is available when medically necessary, particularly for patients with CKD Stage 3A (eGFR 45-59 mL/min/1.73m²). Over 60% of clinical laboratories now offer cystatin C testing, though availability may vary by region.
⚖️ Cystatin C vs Creatinine: Which Test is Better?
Both cystatin C and creatinine are valuable kidney biomarkers, but they have different strengths and limitations. Understanding these differences helps explain why modern guidelines increasingly recommend using both together.
| Feature | Cystatin C | Creatinine |
|---|---|---|
| Affected by muscle mass? | No | Yes - significant limitation |
| Affected by age/sex? | Minimal effect | Yes - requires adjustment |
| Affected by diet? | No | Yes - meat intake affects levels |
| P30 Accuracy (eGFR) | 87-95%[11] | 84-90%[4] |
| Combined accuracy | 94.9% when used together[11] | |
| Predicts CV risk? | Yes - independent predictor[7] | Limited independent value |
| Cost | Higher ($99-159) | Lower (standard panel) |
| Availability | 60%+ of labs | Universal |
Cardiovascular Risk Prediction
Beyond kidney function assessment, cystatin C provides prognostic value for cardiovascular outcomes that creatinine does not match. The LIPID study of 2,716 patients with stable coronary heart disease found that elevated cystatin C predicted:
- Myocardial infarction: HR 1.37 (95% CI: 1.07-1.74) at 6 years[Evidence: B][7]
- Major cardiovascular events: HR 1.47 (95% CI: 1.19-1.82) at 6 years
- These associations persisted at 16-year follow-up for CHD, CV, and all-cause mortality
A meta-analysis of acute coronary syndrome patients found even stronger associations, with elevated cystatin C predicting all-cause mortality (HR 2.53, 95% CI: 1.72-3.72) and major adverse cardiovascular events (HR 3.24, 95% CI: 1.30-8.07), independent of troponin and BNP.[Evidence: A][9]
Mortality Prediction in Metabolic Syndrome
A 2024 cohort study following US adults with metabolic syndrome for a mean of 15.3 years found cystatin C demonstrated greater predictive efficacy for all-cause, cardiovascular, and cancer mortality compared to creatinine, urea nitrogen, uric acid, and C-reactive protein.[Evidence: B][6]
COVID-19 Prognosis
Emerging evidence from a meta-analysis of 25 studies found cystatin C predicts COVID-19 severity (SMD 1.81, p<0.001), mortality (SMD -2.14, p<0.001), and acute kidney injury (SMD 4.56, p=0.04), demonstrating its utility in acute illness prognostication.[Evidence: A][13]
What The Evidence Shows (And Doesn't Show)
What Research Suggests
- Cystatin C detects chronic kidney disease with pooled sensitivity of 88% and specificity of 90% based on meta-analysis of 25 studies with 18,000 participants.[Evidence: A][1]
- Combined creatinine-cystatin C equations achieve P30 accuracy of 94.9%, significantly better than either marker alone.[Evidence: A][11]
- Elevated cystatin C independently predicts cardiovascular events (HR 1.47) and mortality (HR 2.53) in cardiac patients.[Evidence: A][9][Evidence: B][7]
- For diabetic nephropathy screening, cystatin C achieves sensitivity of 86% and AUC of 0.94.[Evidence: A][3]
- Modern race-free equations (CKD-EPI 2021, EKFC 2023) maintain accuracy across diverse populations.[Evidence: A][4][10]
What's NOT Yet Proven
- Optimal screening intervals: Research does not establish how frequently to repeat cystatin C testing for monitoring purposes.
- Pediatric applications: Most meta-analyses focus on adult populations. Pediatric-specific reference ranges and diagnostic accuracy data are limited.
- Threshold variations: Formal sensitivity analysis of diagnostic threshold variations is not available in current meta-analyses.
- Direct clinical outcome improvement: Studies demonstrate diagnostic accuracy, but whether cystatin C-based management improves patient outcomes versus creatinine-based approaches requires more research.
Where Caution Is Needed
- Thyroid dysfunction: Results may be unreliable in patients with untreated hyperthyroidism or hypothyroidism.
- Acute illness: Severe inflammation may transiently affect cystatin C levels independent of kidney function.
- Cost considerations: At $99-159 compared to standard creatinine testing, cost-effectiveness in routine screening requires individual assessment.
- Laboratory variability: While IFCC standardization has improved, inter-laboratory variation persists. Trending should ideally use the same laboratory.
Should YOU Try This?
Best suited for: Elderly patients with reduced muscle mass, bodybuilders or athletes with high muscle mass, diabetics requiring nephropathy monitoring, patients with liver cirrhosis, those needing accurate medication dosing (especially chemotherapy), and anyone with uncertain creatinine results.
Not recommended for: Routine screening in healthy individuals without risk factors (creatinine is adequate). Those with untreated thyroid disorders should have thyroid function normalized first. Single cystatin C measurements should not replace comprehensive kidney evaluation.
Realistic timeline: A single blood draw with results typically available within 1-2 days. Serial testing for trend monitoring may be recommended every 3-12 months depending on clinical situation.
When to consult a professional: Always discuss results with a qualified healthcare provider. Seek evaluation if eGFR is below 60 mL/min/1.73m², if you have symptoms of kidney disease, or if you need accurate GFR for medication dosing decisions.
Frequently Asked Questions
What does high cystatin C mean?
A high cystatin C level indicates that your kidneys are not filtering blood as efficiently as they should. Elevated levels suggest reduced glomerular filtration rate (GFR), which may indicate early or established chronic kidney disease. However, certain factors like hyperthyroidism, high-dose corticosteroids, or inflammation may also raise cystatin C independent of kidney function. Your healthcare provider will interpret results in context of your complete clinical picture, potentially recommending additional testing such as urinalysis, kidney ultrasound, or repeat measurements to confirm findings.
How much does a cystatin C test cost?
Cystatin C testing typically costs between $99 and $159 at direct-to-consumer laboratories such as Walk-In Lab or Request A Test. Hospital and clinic pricing varies significantly based on location and facility. Medicare covers cystatin C testing when medically necessary, particularly for patients with CKD Stage 3A (eGFR 45-59 mL/min/1.73m²). Commercial insurance coverage varies by plan. Contact your insurance provider for specific coverage details, as some plans require prior authorization or specific diagnostic codes.
What is the difference between cystatin C and creatinine?
Cystatin C and creatinine are both kidney biomarkers, but they come from different sources and have different limitations. Creatinine is a breakdown product of muscle metabolism, so levels vary significantly with muscle mass, age, sex, and diet. Cystatin C is produced at a constant rate by all cells regardless of muscle mass. Meta-analysis of 35 studies with 23,667 participants found cystatin C-based formulas have 4.84 mL/min/1.73m² lower bias than creatinine alone, with combined equations achieving 7.50% higher accuracy.
How do you lower cystatin C levels?
Lowering cystatin C levels requires addressing the underlying cause of kidney dysfunction. There is no supplement or medication that directly lowers cystatin C. Evidence-based approaches to protecting kidney function include: controlling blood pressure (target <130/80 mmHg for most CKD patients), managing blood sugar in diabetes, reducing sodium intake, maintaining healthy weight, avoiding nephrotoxic medications like NSAIDs, and stopping smoking. For patients with CKD, SGLT2 inhibitors and ACE inhibitors/ARBs have demonstrated kidney protective effects. Work with your healthcare provider to develop a personalized management plan.
What medications affect cystatin C?
High-dose corticosteroids are the most well-documented medications that may affect cystatin C levels independent of kidney function. Some evidence suggests thyroid hormone replacement may influence levels, as thyroid dysfunction alters cystatin C production. Immunosuppressants like cyclosporine and tacrolimus may affect results, though distinguishing drug effects from nephrotoxicity requires clinical judgment. Unlike creatinine, cystatin C is not affected by trimethoprim, cimetidine, or most common medications. Always inform your healthcare provider of all medications before interpreting cystatin C results.
Can cystatin C detect early kidney disease?
Yes, cystatin C can detect early kidney disease, often before creatinine shows abnormalities. A meta-analysis of 25 studies found cystatin C achieves 88% sensitivity for detecting chronic kidney disease. For acute kidney injury, a meta-analysis of 30 studies found cystatin C rises earlier than creatinine with sensitivity of 82% and AUC of 0.89. This earlier detection is particularly valuable for diabetics, as cystatin C-based assessment of diabetic nephropathy achieves sensitivity of 86% and AUC of 0.94.
What are the limitations of cystatin C testing?
Despite its advantages, cystatin C testing has several limitations. It costs more than creatinine testing and is not universally available at all laboratories. Certain conditions may affect results independent of kidney function, including thyroid disorders, high-dose corticosteroids, severe inflammation, and some malignancies. Standardization across laboratories has improved but is not yet as consistent as creatinine. For these reasons, KDIGO guidelines recommend combined creatinine-cystatin C testing rather than cystatin C alone for optimal accuracy, with P30 accuracy reaching 94.9% when both markers are used.
What causes high cystatin C levels?
The primary cause of elevated cystatin C is reduced kidney function, as the kidneys cannot adequately filter and process this protein. Secondary causes include hyperthyroidism (which increases cystatin C production), high-dose corticosteroid therapy, severe inflammation or infection, certain cancers, and obesity. Unlike creatinine, cystatin C is not elevated by high protein diet, intense exercise, or high muscle mass. If your cystatin C is elevated, your healthcare provider will evaluate these potential causes and may order additional tests to determine whether kidney dysfunction or another factor is responsible.
Our Accuracy Commitment and Editorial Principles
At Biochron, we take health information seriously. Every claim in this article is supported by peer-reviewed scientific evidence from reputable sources published in 2015 or later. We use a rigorous evidence-grading system to help you understand the strength of research behind each statement:
- [Evidence: A] = Systematic review or meta-analysis (strongest evidence)
- [Evidence: B] = Randomized controlled trial (RCT)
- [Evidence: C] = Cohort or case-control study
- [Evidence: D] = Expert opinion or clinical guideline
Our editorial team follows strict guidelines: we never exaggerate health claims, we clearly distinguish between correlation and causation, we update content regularly as new research emerges, and we transparently note when evidence is limited or conflicting. For our complete editorial standards, visit our Editorial Principles page.
This article is for informational purposes only and does not constitute medical advice. Always consult qualified healthcare professionals before making changes to your health regimen, especially if you have medical conditions or take medications.
References
- 1 . Diagnostic accuracy of serum cystatin C in chronic kidney disease: a meta-analysis, Lu Wei et al., Clinical Nephrology, 2015, 84(2):86-94. PubMed [Evidence: A]
- 2 . Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials, Zhenzhu Yong et al., Scientific Reports, 2017, 7:41012. PubMed [Evidence: A]
- 3 . Diagnostic value of serum cystatin C for diabetic nephropathy: a meta-analysis, Xueling Liao et al., BMC Endocrine Disorders, 2022, 22(1):149. PubMed [Evidence: A]
- 4 . New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race, Lesley A Inker et al., New England Journal of Medicine, 2021, 385(19):1737-1749. PubMed [Evidence: A]
- 5 . KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease, KDIGO Work Group, Kidney International, 2024. KDIGO [Evidence: D]
- 6 . Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US Adults With Metabolic Syndrome, Xiaoying Song et al., Journal of Clinical Endocrinology & Metabolism, 2024, 109(11):2905-2919. PubMed [Evidence: B]
- 7 . Circulating Cystatin C Is an Independent Risk Marker for Cardiovascular Outcomes: The LIPID Study, Malcolm West et al., Journal of the American Heart Association, 2022, 11(5):e020745. PubMed [Evidence: B]
- 8 . Carboplatin Dosing on the Basis of Renal Function: 30+ Years after Calvert, Michael H Schwenk, Kidney360, 2024, 5(2):271-273. DOI [Evidence: B]
- 9 . Prognostic value of cystatin C in patients with acute coronary syndrome: A systematic review and meta-analysis, Ying Sun et al., European Journal of Clinical Investigation, 2021, 51(3):e13440. PubMed [Evidence: A]
- 10 . Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex, Hans Pottel et al., New England Journal of Medicine, 2023, 388:333-343. PubMed [Evidence: A]
- 11 . Accuracy of glomerular filtration rate estimation using creatinine and cystatin C: the eGFR-C study, Edmund J Lamb et al., Health Technology Assessment, 2024, 28(35):1-169. PubMed [Evidence: A]
- 12 . Cystatin C as a GFR Estimation Marker in Acute and Chronic Illness: A Systematic Review, Ogechi M Adingwupu et al., Kidney Medicine, 2023, 5(12):100727. PubMed [Evidence: A]
- 13 . Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis, Michal Matuszewski et al., International Journal of Environmental Research and Public Health, 2022, 19(21):14607. PubMed [Evidence: A]
- 14 . Estimating Glomerular Filtration Rate in Cirrhosis Using Creatinine-Based and Cystatin C-Based Equations: Meta-Analysis, Prianka Singapura et al., Liver Transplantation, 2021, 27(11):1538-1545. PubMed [Evidence: A]
- 15 . Comparison of bias and accuracy using cystatin C and creatinine in CKD-EPI equations for GFR estimation, Lu-Xi Zou et al., European Journal of Internal Medicine, 2020, 80:62-69. PubMed [Evidence: A]
- 16 . Accuracy of GFR estimating equations based on creatinine, cystatin C or both in routine care, Edouard L Fu et al., Nephrology Dialysis Transplantation, 2024, 39(5):914-922. PubMed [Evidence: A]
- 17 . Association Between Increased Levels of Cystatin C and the Development of Cardiovascular Events or Mortality: A Systematic Review and Meta-Analysis, Xinyi Meng et al., Cardiology Research and Practice, 2019, 2019:9276572. PubMed [Evidence: A]
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