Difference between estimated glomerular filtration rate based on cystatin C versus creatinine and cardiovascular–kidney–metabolic health

作者：Xiaoyan Wu, Wuming Hu, Jian Xu, Jiayi Shen, Li Lin, Jingshuai Zhu, Tiemin Wei, Lingchun Lv · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2024.1477343 · 被引用次数：4 · 研究领域：Chronic Kidney Disease and Diabetes、Dialysis and Renal Disease Management、Birth, Development, and Health

Background The difference between the estimated glomerular filtration rate (eGFR) calculated from cystatin C and creatinine (eGFRdiff) serves as a biomarker of kidney function impairment. However, the role of eGFRdiff in cardiovascular–kidney–metabolic (CKM) health and its impact on mortality in CKM syndrome patients has not yet been studied. Methods This study included 3,622 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2004. Weighted ordinal logistic regression was used to explore the link between eGFRdiff and CKM health, while weighted Cox regression was used to examine the relationship between eGFRdiff and mortality in CKM syndrome patients. Restricted cubic splines (RCSs) were used to analyze the dose–response relationship. Results The common odds ratio (cOR) per 10 mL/min/1.73m 2 increase in eGFRdiff was 0.86 [95% confidence interval (CI), 0.81 to 0.91]. Compared to the midrange eGFRdiff, the cOR values for the negative and positive eGFRdiff were 1.88 [95% CI, 1.23 to 2.88] and 0.69 [95% CI, 0.58 to 0.83], respectively. During a median follow-up of 201 months, 853 participants died from all causes, while 265 died due to cardiovascular causes. The hazard ratios (HRs) per 10 mL/min/1.73m 2 increase in eGFRdiff were 0.88 [95% CI, 0.83 to 0.93] for all-cause mortality and 0.90 [95% CI, 0.81 to 1.00] for cardiovascular mortality cases. Compared to the participants with a midrange eGFRdiff, those with negative eGFRd...