Comparison of the association intensity of creatinine and cystatin C with hyperphosphatemia and hyperparathyroidism in patients with chronic kidney disease

• Published in: Scientific reports Vol. 13; no. 1; p. 3855
• Main Authors: Min, Byungju, Yun, Sung-Ro, Yoon, Se-Hee, Kim, Jong-Dai, Hwang, Wan Jin, Hwang, Won Min, Park, Yohan
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 08.03.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4022; 692/4022/272; Aged; Creatinine; Cystatin C; Epidermal growth factor receptors; Glomerular filtration rate; Glomerular Filtration Rate - physiology; Humanities and Social Sciences; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary - complications; Hyperphosphatemia; Hyperphosphatemia - complications; Kidney diseases; Kidneys; multidisciplinary; Physiology; Renal Insufficiency, Chronic; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-31048-2

Herein, we compared the association intensity of estimated glomerular filtration rate (eGFR) equations using creatinine (Cr) or cystatin C (CysC) with hyperphosphatemia and secondary hyperparathyroidism occurrence, which reflect the physiological changes occurring during chronic kidney disease (CKD) progression. This study included 639 patients treated between January 2019 and February 2022. The patients were divided into low- and high-difference groups based on the median value of the difference between the Cr-based eGFR (eGFR Cr ) and CysC-based eGFR (eGFR CysC ). Sociodemographic and laboratory factors underlying a high difference between eGFR Cr and eGFR CysC were analyzed. The association intensity of eGFR Cr , eGFR CysC and both Cr- and CysC-based eGFR (eGFR Cr-CysC ) was compared using the area under the receiver operating characteristic curve (AuROC) values for hyperphosphatemia and hyperparathyroidism occurrence in the overall cohort and the low- and high-difference groups. Age > 70 years and CKD grade 3 based on eGFR Cr were significant factors affecting the high differences. eGFR CysC and eGFR Cr-CysC showed higher AuROC values than that of eGFR Cr , especially in the high-difference group and in patients with CKD grade 3. Our results show that CysC should be evaluated in patients with significant factors, including age > 70 years and CKD grade 3, to accurately assess kidney function to better determine the physiological changes in CKD progression and predict prognosis accurately.