Abstract: SA-OR34
Discrepancy Between eGFR Cystatin C and eGFR Creatinine in Recently Hospitalized Adults
Session Information
- Epidemiology of CKD Progression: Who, Why, and When?
November 04, 2023 | Location: Room 119, Pennsylvania Convention Center
Abstract Time: 05:24 PM - 05:33 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Wen, Yumeng, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Farrington, Danielle Kacie, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Thiessen Philbrook, Heather, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Menez, Steven, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Moledina, Dennis G., Yale School of Medicine, New Haven, Connecticut, United States
- Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Go, Alan S., The Permanente Medical Group Inc, Oakland, California, United States
- Hsu, Chi-yuan, University of California San Francisco, San Francisco, California, United States
- Himmelfarb, Jonathan, University of Washington, Seattle, Washington, United States
- Chinchilli, Vernon M., Penn State College of Medicine, Hershey, Pennsylvania, United States
- Kaufman, James S., New York University Grossman School of Medicine, New York, New York, United States
- Kimmel, Paul L., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States
- Garg, Amit X., London Health Sciences Centre, London, Ontario, Canada
- Grams, Morgan, New York University Grossman School of Medicine, New York, New York, United States
- Parikh, Chirag R., Johns Hopkins Medicine, Baltimore, Maryland, United States
Background
Having a lower estimated glomerular filtration rate using cystatin C (eGFRcys) than creatinine (eGFRcr) is associated with a higher risk of cardiac disease and death in the outpatient setting. However, the distribution of this discrepancy and its prognostic values in recently hospitalized adults are not well described.
Methods
In 1534 hospitalized adults enrolled in the Assessment, Serial Evaluation, and Subsequent Sequelae of Acute Kidney Injury (ASSESS-AKI) cohort, we characterized the difference between eGFRcys and eGFRcr at 3 months after discharge. We used survival analysis to determine the associations between differences in eGFRcys and eGFRcr and risk of end-stage kidney disease (ESKD), major adverse cardiac events (MACE), first heart failure hospitalization, and death after a median follow up of 4.7 years.
Results
The mean age of study participants was 64.5 years, 37.3% are female, and 50% had AKI during hospitalization. At 3 months after hospitalization, eGFRcys was lower than eGFRcr by a large margin (Table). The difference between eGFRcys and eGFRcr at 3 months was 4.4% (2.4%- 6.5%) and 7.1% (3.8%- 10.5%) larger in those with AKI and sepsis during hospitalization, respectively. Having a lower in eGFRcys than eGFRcr was further associated with a higher risk of MACE, heart failure, ESKD, and death (Table), and these associations are consistent in participants with and without AKI (p for interaction with AKI all > 0.1).
Conclusion
By systematically measuring eGFRcys and eGFRcr in a cohort of recently hospitalized adults, we found that having lower eGFRcys than eGFRcr is commonly observed and provides additional prognostication for adverse clinical events.
Funding
- NIDDK Support