ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: FR-PO879

Large Discordances Between Creatinine (Cr) and Cystatin C-Based Estimated Glomerular Filtration Rates (eGFR) Are Associated with Adverse Outcomes in a Nationally Representative Cohort of Older Adults

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology


  • Katz, Nurit S., Mass General Brigham Inc, Boston, Massachusetts, United States
  • Rieu-Werden, Meghan L., Mass General Brigham Inc, Boston, Massachusetts, United States
  • Shah, Sachin J., Mass General Brigham Inc, Boston, Massachusetts, United States
  • Sise, Meghan E., Mass General Brigham Inc, Boston, Massachusetts, United States

Creatinine based eGFR may be overestimated in adults with sarcopenia. While the combined equation CKD-EPI eGFR-CRE-CYS may be more accurate on a population level, patients whose eGFR-CYS is significantly lower than eGFR-CRE (eGFR discordance) may be at high risk for adverse outcomes.


In a longitudinal cohort study of adults 65+ yrs, from the Health and Retirement Study 2016 Venous Blood Study, we calculated eGFR-CRE and eGFR-CYS with current CKD-EPI. Outcomes included fall, hip fracture, hospitalization, and death 2 years from baseline assessment. We plotted the relationship between eGFR discordance and likelihood of outcomes in each ventile using a loess plot with span 75%. We fit separate multivariable logistic regression to determine the association between large eGFR discordances (i.e. >30%) and each outcome, adjusted for confounders.


There were 5574 participants with a mean age of 75 ±7.2 yrs, 58% women, 80% white, and 10% Hispanic. 35% had chronic kidney disease (CKD) (eGFR-CRE-CYS <60 ml/min/1.73m2). 30% had eGFR-CYS >30% lower than eGFR-CRE. We found increasing rates of falls, hospitalizations, and death at higher eGFR discordances [Figure 1]. In adjusted analyses, large eGFR discordance was associated with a significantly greater odd of fall , hospitalization , and death [Figure 2].


Older adults with a large eGFR discordances have a greater risk of adverse outcomes, possibly due to misdosing of renally cleared medications, occult CKD or sarcopenia.