Estimating glomerular filtration rate in diabetes: a comparison of cystatin-C- and creatinine-based methods

Diabetologia. 2006 Jul;49(7):1686-9. doi: 10.1007/s00125-006-0275-7. Epub 2006 May 3.


Aims/hypothesis: We compared the predictive performance of a GFR based on serum cystatin C levels with commonly used creatinine-based methods in subjects with diabetes.

Subjects, materials and methods: In a cross-sectional study of 251 consecutive clinic patients, the mean reference (plasma clearance of (99m)Tc-diethylene-triamine-penta-acetic acid) GFR (iGFR) was 88+/-2 ml min(-1) 1.73 m(-2). A regression equation describing the relationship between iGFR and 1/cystatin C levels was derived from a test population (n=125) to allow for the estimation of GFR by cystatin C (eGFR-cystatin C). The predictive performance of eGFR-cystatin C, the Modification of Diet in Renal Disease 4 variable formula (MDRD-4) and Cockcroft-Gault (C-G) formulas were then compared in a validation population (n=126).

Results: There was no difference in renal function (ml min(-1) 1.73 m(-2)) as measured by iGFR (89.2+/-3.0), eGFR-cystatin C (86.8+/-2.5), MDRD-4 (87.0+/-2.8) or C-G (92.3+/-3.5). All three estimates of renal function had similar precision and accuracy.

Conclusions/interpretation: Estimates of GFR based solely on serum cystatin C levels had the same predictive potential when compared with the MDRD-4 and C-G formulas.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Creatinine / analysis*
  • Cross-Sectional Studies
  • Cystatin C
  • Cystatins / analysis*
  • Glomerular Filtration Rate*
  • Humans
  • Middle Aged
  • Predictive Value of Tests
  • Sensitivity and Specificity


  • CST3 protein, human
  • Cystatin C
  • Cystatins
  • Creatinine