{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:25:02Z","timestamp":1793993102635,"version":"4.8.0"},"reference-count":46,"publisher":"American Medical Association (AMA)","issue":"21","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2025,12,2]]},"abstract":"\n Importance<\/jats:title>\n Estimated glomerular filtration rates (eGFRs) can differ according to whether creatinine or cystatin C is used for the eGFR calculation, but the prevalence and importance of these differences remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To evaluate the prevalence of a discordance between cystatin C\u2013based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcr), identify characteristics associated with greater discordance, and evaluate associations of discordance with adverse outcomes.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n Participants in the Chronic Kidney Disease Prognosis Consortium (CKD-PC).<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Participants with concurrent cystatin C and creatinine measurements and clinical outcome measurement.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Between April 2024 and August 2025, data were synthesized using individual-level meta-analysis.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary independent measurement was a large negative eGFR difference (eGFRdiff), defined as an eGFRcys that was at least 30% lower than eGFRcr. Secondary (dependent) outcomes included all-cause and cardiovascular mortality, atherosclerotic cardiovascular disease, heart failure, and kidney failure with replacement therapy.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 821\u202f327 individuals from 23 outpatient cohorts (mean [SD] age, 59 [12] years; 48% female; 13.5% with diabetes; 40% with hypertension) and 39\u202f639 individuals from 2 inpatient cohorts (mean [SD] age, 67 [16] years; 31% female; 30% with diabetes; 72% with hypertension) were included. Among outpatient participants, 11% had a large negative eGFRdiff (range, 3%-50%). Among inpatients, 35% had a large negative eGFRdiff. Among outpatient participants, at a mean (SD) follow-up of 11 (4) years, a large negative eGFRdiff, compared with an eGFRdiff between \u221230% and 30%, was associated with higher rates of all-cause mortality (28.4 vs 16.8 per 1000 person-years [PY]; hazard ratio [HR], 1.69 [95% CI, 1.57-1.82]), cardiovascular mortality (6.1 vs 3.8 per 1000 PY; HR, 1.61 [95% CI, 1.48-1.76]), atherosclerotic cardiovascular disease (13.3 vs 9.8 per 1000 PY; HR, 1.35 [95% CI, 1.27-1.44]), heart failure (13.2 vs 8.6 per 1000 PY; HR, 1.54 [95% CI, 1.40-1.68]), and kidney failure with replacement therapy (2.7 vs 2.1 per 1000 PY; HR, 1.29 [95% CI, 1.13-1.47]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In the CKD-PC, 11% of outpatient participants and 35% of hospitalized patients had an eGFRcys that was at least 30% lower than their eGFRcr. In the outpatient setting, presence of eGFRcys at least 30% lower than eGFRcr was associated with significantly higher rates of all-cause mortality, cardiovascular events, and kidney failure.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2025.17578","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T20:30:20Z","timestamp":1762547420000},"page":"1915","source":"Crossref","is-referenced-by-count":34,"title":["Discordance in Creatinine- and Cystatin C\u2013Based eGFR and Clinical Outcomes"],"prefix":"10.1001","volume":"334","author":[{"given":"Michelle M.","family":"Estrella","sequence":"first","affiliation":[{"name":"Kidney Health Research Collaborative, University of California San Francisco and San Francisco Veterans Affairs Health Care System, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoshana H.","family":"Ballew","sequence":"additional","affiliation":[{"name":"Optimal Aging Institute, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Sang","sequence":"additional","affiliation":[{"name":"Optimal Aging Institute, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan E.","family":"Grams","sequence":"additional","affiliation":[{"name":"Division of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Coresh","sequence":"additional","affiliation":[{"name":"Optimal Aging Institute, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Surapaneni","sequence":"additional","affiliation":[{"name":"Division of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Alencar de Pinho","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"\u00c4rnl\u00f6v","sequence":"additional","affiliation":[{"name":"School of Health and Social Studies, Dalarna University, Falun, Sweden"},{"name":"Department of Neurobiology, Care Sciences and Society, Family Medicine and Primary Care Unit, Karolinska Institutet, Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Brenner","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology and Aging Research, German Cancer Research Center and Network Aging Research, Heidelberg University, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Jesus","family":"Carrero","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Huddinge, Sweden"},{"name":"Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa K.","family":"Chen","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, University of California San Francisco and San Francisco Veterans Affairs Health Care System, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie L.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Renal Electrolyte and Hypertension, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Cushman","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Pathology and Laboratory Medicine, University of Vermont Larner College of Medicine, Burlington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron T.","family":"Gansevoort","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Jen","family":"Hwang","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts"},{"name":"Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley A.","family":"Inker","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim H.","family":"Ix","sequence":"additional","affiliation":[{"name":"Nephrology Section, Veterans Affairs San Diego Health Care System, San Diego, California"},{"name":"Division of Nephrology-Hypertension, University of California San Diego, La Jolla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Kabasawa","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan"},{"name":"Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuneo","family":"Konta","sequence":"additional","affiliation":[{"name":"Department of Public Health and Hygiene, Yamagata University, Yamagata, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Lees","sequence":"additional","affiliation":[{"name":"School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom"},{"name":"Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevan R.","family":"Polkinghorne","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine and Department of Medicine, Monash University, Clayton, Victoria, Australia"},{"name":"Department of Nephrology, Monash Medical Centre, Monash Health, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Shlipak","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, University of California San Francisco and San Francisco Veterans Affairs Health Care System, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin W. M.","family":"Vernooij","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Centre for Kidney and Bladder Health, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Levey","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Uwe","family":"Eckardt","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"},{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa K","family":"Chen","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Sang","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan E","family":"Grams","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Coresh","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Chadban","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevan","family":"Polkinghorne","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Bansal","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim H","family":"Ix","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G","family":"Shlipak","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Metzger","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedicte","family":"Stengel","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Landray","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John N","family":"Townend","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Emberson","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-yuan","family":"Hsu","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Anderson","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Brenner","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietrich","family":"Rothenbacher","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Sch\u00f6ttker","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Stocker","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Levy","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Larson","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kottgen","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"Sekula","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla T","family":"Schultheiss","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus P","family":"Schneider","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Kumar","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Sahay","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narayan","family":"Prasad","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin WM","family":"Vernooij","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S","family":"Levey","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley A","family":"Inker","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sarnak","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando M","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Cushman","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan JL","family":"Bakker","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyanne M","family":"Kieneker","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"van Londen","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Cheung","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titi","family":"Ilori","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard L","family":"Fu","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Laure","family":"Faucon","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Caldinelli","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Creon","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuneo","family":"Konta","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunobu","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Nagase","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S","family":"Lees","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick B","family":"Mark","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Larsson","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilmantas","family":"Giedraitis","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Kabasawa","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Ito","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junta","family":"Tanaka","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiei","family":"Narita","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Estrella","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoshana H","family":"Ballew","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Jesus","family":"Carrero","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron T","family":"Gansevoort","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Matsushita","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea","family":"Nitsch","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Yee-Moon","family":"Wang","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina M","family":"Flaherty","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Surapaneni","sequence":"additional","affiliation":[{"name":"for the Chronic Kidney Disease Prognosis Consortium Investigators and Collaborators"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4S","key":"joi250078r1","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the evaluation and management of chronic kidney disease.","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"issue":"10","key":"joi250078r2","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.34067\/KID.0003202022","article-title":"Advantages, limitations, and clinical considerations in using cystatin C to estimate GFR.","volume":"3","author":"Chen","year":"2022","journal-title":"Kidney360"},{"issue":"10","key":"joi250078r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2023.100710","article-title":"Discordance between creatinine-based and cystatin C-based estimated GFR: interpretation according to performance compared to measured GFR.","volume":"5","author":"Wang","year":"2023","journal-title":"Kidney Med"},{"issue":"7","key":"joi250078r4","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1681\/ASN.0000000000000128","article-title":"Accuracy of GFR estimating equations in patients with discordances between creatinine and cystatin C-based estimations.","volume":"34","author":"Fu","year":"2023","journal-title":"J Am Soc Nephrol"},{"issue":"2","key":"joi250078r5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.48940","article-title":"Association of intraindividual difference in estimated glomerular filtration rate by creatinine vs cystatin C and end-stage kidney disease and mortality.","volume":"5","author":"Chen","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"6","key":"joi250078r6","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1053\/j.ajkd.2022.05.011","article-title":"Association of intra-individual differences in estimated GFR by creatinine versus cystatin C with incident heart failure.","volume":"80","author":"Chen","year":"2022","journal-title":"Am J Kidney Dis"},{"issue":"6","key":"joi250078r7","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1053\/j.ajkd.2020.05.017","article-title":"The difference between cystatin C- and creatinine-based estimated GFR and associations with frailty and adverse outcomes: a cohort analysis of the Systolic Blood Pressure Intervention Trial (SPRINT).","volume":"76","author":"Potok","year":"2020","journal-title":"Am J Kidney Dis"},{"issue":"5","key":"joi250078r8","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1053\/j.ajkd.2023.04.002","article-title":"Discordances between creatinine- and cystatin C-based estimated GFR and adverse clinical outcomes in routine clinical practice.","volume":"82","author":"Carrero","year":"2023","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"joi250078r9","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1053\/j.ajkd.2011.05.019","article-title":"Expressing the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) cystatin C equations for estimating GFR with standardized serum cystatin C values.","volume":"58","author":"Inker","year":"2011","journal-title":"Am J Kidney Dis"},{"issue":"11","key":"joi250078r10","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1515\/CCLM.2010.318","article-title":"First certified reference material for cystatin C in human serum ERM-DA471\/IFCC.","volume":"48","author":"Grubb","year":"2010","journal-title":"Clin Chem Lab Med"},{"issue":"19","key":"joi250078r11","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New creatinine- and cystatin C-based equations to estimate GFR without race.","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med"},{"issue":"1","key":"joi250078r12","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1056\/NEJMoa1114248","article-title":"Estimating glomerular filtration rate from serum creatinine and cystatin C.","volume":"367","author":"Inker","year":"2012","journal-title":"N Engl J Med"},{"issue":"2","key":"joi250078r13","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1053\/j.ajkd.2021.08.003","article-title":"A unifying approach for GFR estimation: recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease.","volume":"79","author":"Delgado","year":"2022","journal-title":"Am J Kidney Dis"},{"issue":"20","key":"joi250078r14","doi-asserted-by":"publisher","first-page":"2060","DOI":"10.1001\/jama.2022.15404","article-title":"Reported awareness and adoption of 2021 estimated glomerular filtration rate equations among US clinical laboratories, March 2022.","volume":"328","author":"Genzen","year":"2022","journal-title":"JAMA"},{"issue":"4","key":"joi250078r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2024.100796","article-title":"Cystatin C- and creatinine-based estimated GFR differences: prevalence and predictors in the UK Biobank.","volume":"6","author":"Chen","year":"2024","journal-title":"Kidney Med"},{"issue":"3","key":"joi250078r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2022.100416","article-title":"Cystatin C- and creatinine-based glomerular filtration rate estimation differences and muscle quantity and functional status in older adults: the Health, Aging, and Body Composition study.","volume":"4","author":"Potok","year":"2022","journal-title":"Kidney Med"},{"issue":"9","key":"joi250078r17","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.2215\/CJN.0000000000000217","article-title":"Discrepancies between cystatin C-based and creatinine-based eGFR.","volume":"18","author":"Farrington","year":"2023","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4","key":"joi250078r19","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1111\/nep.12789","article-title":"Indian chronic kidney disease study: design and methods.","volume":"22","author":"Kumar","year":"2017","journal-title":"Nephrology (Carlton)"},{"issue":"8","key":"joi250078r20","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1093\/ndt\/gft388","article-title":"The French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort study.","volume":"29","author":"Stengel","year":"2014","journal-title":"Nephrol Dial Transplant"},{"issue":"9","key":"joi250078r21","doi-asserted-by":"publisher","first-page":"2820","DOI":"10.1093\/ndt\/gfq848","article-title":"The combined contribution of albuminuria and glomerular filtration rate to the prediction of cardiovascular mortality in elderly men.","volume":"26","author":"Nerpin","year":"2011","journal-title":"Nephrol Dial Transplant"},{"issue":"12","key":"joi250078r22","doi-asserted-by":"publisher","first-page":"2086","DOI":"10.1093\/ndt\/gfw354","article-title":"Prevalence and recognition of chronic kidney disease in Stockholm healthcare.","volume":"31","author":"Gasparini","year":"2016","journal-title":"Nephrol Dial Transplant"},{"issue":"4","key":"joi250078r23","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1038\/sj.ki.5001504","article-title":"Prevalence and risk factor analysis of microalbuminuria in Japanese general population: the Takahata study.","volume":"70","author":"Konta","year":"2006","journal-title":"Kidney Int"},{"issue":"3","key":"joi250078r24","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1053\/ajkd.2001.26850","article-title":"Epidemiological evaluation of known and suspected cardiovascular risk factors in chronic renal impairment.","volume":"38","author":"Landray","year":"2001","journal-title":"Am J Kidney Dis"},{"issue":"13","key":"joi250078r25","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1056\/NEJM199403313301301","article-title":"The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease.","volume":"330","author":"Klahr","year":"1994","journal-title":"N Engl J Med"},{"issue":"2","key":"joi250078r26","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.ypmed.2008.10.026","article-title":"Epidemiology of chronic kidney disease: results from a population of older adults in Germany.","volume":"48","author":"Zhang","year":"2009","journal-title":"Prev Med"},{"issue":"3","key":"joi250078r27","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1159\/000086678","article-title":"The Reasons for Geographic and Racial Differences in Stroke study: objectives and design.","volume":"25","author":"Howard","year":"2005","journal-title":"Neuroepidemiology"},{"issue":"3","key":"joi250078r28","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1093\/ndt\/gfu294","article-title":"Disease burden and risk profile in referred patients with moderate chronic kidney disease: composition of the German Chronic Kidney Disease (GCKD) cohort.","volume":"30","author":"Titze","year":"2015","journal-title":"Nephrol Dial Transplant"},{"issue":"1","key":"joi250078r29","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.amjcard.2008.02.095","article-title":"Chronic kidney disease as a predictor of cardiovascular disease (from the Framingham Heart Study).","volume":"102","author":"Parikh","year":"2008","journal-title":"Am J Cardiol"},{"issue":"11","key":"joi250078r30","doi-asserted-by":"publisher","first-page":"2073","DOI":"10.2215\/CJN.04260415","article-title":"Chronic Renal Insufficiency Cohort Study (CRIC): overview and summary of selected findings.","volume":"10","author":"Denker","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"issue":"12","key":"joi250078r32","doi-asserted-by":"publisher","first-page":"2617","DOI":"10.1681\/ASN.2009010025","article-title":"Change in estimated GFR associates with coronary heart disease and mortality.","volume":"20","author":"Matsushita","year":"2009","journal-title":"J Am Soc Nephrol"},{"issue":"3","key":"joi250078r33","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1159\/000212381","article-title":"Rate of kidney function decline in older adults: a comparison using creatinine and cystatin C.","volume":"30","author":"Shlipak","year":"2009","journal-title":"Am J Nephrol"},{"issue":"6","key":"joi250078r34","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1038\/ki.2012.137","article-title":"Multifactorial intervention with nurse practitioners does not change cardiovascular outcomes in patients with chronic kidney disease.","volume":"82","author":"van Zuilen","year":"2012","journal-title":"Kidney Int"},{"issue":"14","key":"joi250078r35","doi-asserted-by":"publisher","first-page":"1777","DOI":"10.1161\/01.CIR.0000031732.78052.81","article-title":"Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population.","volume":"106","author":"Hillege","year":"2002","journal-title":"Circulation"},{"issue":"7726","key":"joi250078r36","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1038\/s41586-018-0579-z","article-title":"The UK Biobank resource with deep phenotyping and genomic data.","volume":"562","author":"Bycroft","year":"2018","journal-title":"Nature"},{"issue":"19","key":"joi250078r37","doi-asserted-by":"publisher","first-page":"2421","DOI":"10.1001\/jama.288.19.2421","article-title":"Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial.","volume":"288","author":"Wright","year":"2002","journal-title":"JAMA"},{"issue":"3","key":"joi250078r38","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1053\/j.ajkd.2008.06.025","article-title":"Cystatin C and carotid intima-media thickness in asymptomatic adults: the Multi-Ethnic Study of Atherosclerosis (MESA).","volume":"53","author":"Bui","year":"2009","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"joi250078r39","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1053\/j.ajkd.2009.12.011","article-title":"Comparison of the prevalence and mortality risk of CKD in Australia using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study GFR estimating equations: the AusDiab (Australian Diabetes, Obesity and Lifestyle) study.","volume":"55","author":"White","year":"2010","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"joi250078r40","doi-asserted-by":"publisher","first-page":"170","DOI":"10.2188\/jea.JE20180220","article-title":"Study design and baseline profiles of participants in the Uonuma CKD cohort study in Niigata, Japan.","volume":"30","author":"Kabasawa","year":"2020","journal-title":"J Epidemiol"},{"issue":"6","key":"joi250078r41","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1053\/j.ajkd.2020.05.018","article-title":"The difference between cystatin C- and creatinine-based estimated GFR and incident frailty: an analysis of the Cardiovascular Health Study (CHS).","volume":"76","author":"Potok","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"joi250078r42","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2024.110801","article-title":"Discrepancy between estimated glomerular filtration rate by creatinine versus cystatin C in different patient care settings.","volume":"131-132","author":"Liu","year":"2024","journal-title":"Clin Biochem"},{"issue":"3","key":"joi250078r43","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.027079","article-title":"Differential associations of cystatin C versus creatinine-based kidney function with risks of cardiovascular event and mortality among South Asian individuals in the UK Biobank.","volume":"12","author":"Chen","year":"2023","journal-title":"J Am Heart Assoc"},{"issue":"20","key":"joi250078r44","doi-asserted-by":"publisher","first-page":"2049","DOI":"10.1056\/NEJMoa043161","article-title":"Cystatin C and the risk of death and cardiovascular events among elderly persons.","volume":"352","author":"Shlipak","year":"2005","journal-title":"N Engl J Med"},{"issue":"10","key":"joi250078r45","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1056\/NEJMoa1214234","article-title":"Cystatin C versus creatinine in determining risk based on kidney function.","volume":"369","author":"Shlipak","year":"2013","journal-title":"N Engl J Med"},{"issue":"13","key":"joi250078r46","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1001\/jama.2023.17002","article-title":"Estimated glomerular filtration rate, albuminuria, and adverse outcomes: an individual-participant data meta-analysis.","volume":"330","author":"Grams","year":"2023","journal-title":"JAMA"},{"key":"joi250078r18","volume-title":"2024 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States","author":"United States Renal Data System","year":"2024"},{"key":"joi250078r31","unstructured":"US Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey. Accessed January 19, 2017. https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/Default.aspx"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2841167\/jama_estrella_2025_oi_250078_1764017915.15436.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T16:00:31Z","timestamp":1764691231000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2841167"}},"subtitle":["A Meta-Analysis"],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":46,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2025,12,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2025.17578","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12,2]]}}}