Cystatin C-based equations in renal transplantation: moving toward a better glomerular filtration rate prediction?

Transplantation. 2008 Jun 27;85(12):1855-8. doi: 10.1097/TP.0b013e3181744225.


Creatinine-based glomerular filtration rate (GFR) estimators perform poorly in renal transplant recipients. Cystatin C might be a better alternative to serum creatinine in assessing renal graft function. We compared several cystatin C-based equations with the modification diet renal disease (MDRD) equation in 120 adult renal transplant recipients for whom the GFR was measured by the gold standard inulin clearance. Mean inulin-measured GFR was 52.6 mL/min/1.73 m (range, 13-119). The Hoek, Rule, Le Bricon, and Filler cystatin C-based formulas showed significantly better performances (accuracy 30% of 82%, 81%, 78%, and 71%), than the MDRD equation (58%, Mac Nemar test, P<0.01). Sensitivity to detect a GFR below 60 mL/min/1.73 m was significantly higher for the Hoek and the Rule equations (0.95, 95% CI 0.91-1) than for the MDRD equation (0.76, 95% CI 0.67-0.85). These data confirm that cystatin C as a GFR marker offers significant advantages over creatinine in renal transplantation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Creatinine / blood*
  • Cystatin C
  • Cystatins / blood*
  • Female
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Inulin / metabolism
  • Kidney / physiology
  • Kidney Function Tests
  • Kidney Transplantation / physiology*
  • Male
  • Middle Aged
  • Models, Biological*
  • Predictive Value of Tests


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