{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:43:49Z","timestamp":1781880229667,"version":"3.54.5"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Exp Nephrol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Discrepancies between the cystatin C-based estimated glomerular filtration rate (eGFRcys) and the creatinine-based estimated glomerular filtration rate (eGFRcr) have been linked to adverse outcomes in Western populations. However, their prognostic significance in community-dwelling Japanese individuals remains unclear. Therefore, we conducted a prospective cohort study to evaluate this association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed data from 1308 participants who underwent simultaneous measurements of serum creatinine and cystatin C levels between 2004 and 2006, with a median follow-up of 18.5 years. The discrepancy (eGFRdiff = eGFRcys \u2212 eGFRcr) was categorized into three groups: a low group (&lt; \u2212 10 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ), a reference group (\u2212 10 to 10 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ), and a high group (\u2265 10 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ). All-cause and cardiovascular mortality were assessed using Kaplan\u2013Meier curves, Cox proportional hazards models, and restricted cubic spline analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the follow-up period, 386 participants (29.5%) died, including 120 cardiovascular-related deaths. Compared with the reference group, individuals in the eGFRdiff &lt; \u2212 10 group exhibited a significantly higher risk of all-cause mortality (hazard ratio [HR]: 1.41; 95% confidence interval [CI]: 1.10\u20131.80), whereas those in the \u2265 10 group showed a lower risk (HR: 0.56; 95% CI: 0.33\u20130.97). No significant association was observed with cardiovascular mortality. Incorporating eGFRdiff into the baseline models improved discrimination for both all-cause and cardiovascular mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The discrepancy between eGFRcys and eGFRcr levels is an independent predictor of all-cause mortality in a community-based Japanese population. eGFRdiff may serve as a simple yet informative marker for identifying individuals at increased risk of death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10157-026-02853-6","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T07:44:57Z","timestamp":1774597497000},"page":"883-891","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Discrepancy between cystatin C-based and creatinine-based eGFR predicts all-cause mortality in a community-based population: the Takahata study"],"prefix":"10.1007","volume":"30","author":[{"given":"Takaya","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunobu","family":"Ichikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuko","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7681-6469","authenticated-orcid":false,"given":"Tsuneo","family":"Konta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"2853_CR1","doi-asserted-by":"publisher","first-page":"2073","DOI":"10.1016\/S0140-6736(10)60674-5","volume":"375","author":"K Matsushita","year":"2010","unstructured":"Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375:2073\u201381.","journal-title":"Lancet."},{"key":"2853_CR2","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1053\/j.ajkd.2008.12.034","volume":"53","author":"S Matsuo","year":"2009","unstructured":"Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982\u201392.","journal-title":"Am J Kidney Dis."},{"key":"2853_CR3","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1053\/j.ajkd.2012.07.007","volume":"61","author":"M Horio","year":"2013","unstructured":"Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S, Collaborators Developing the Japanese Equation for Estimated GFR. GFR estimation using standardized serum cystatin C in Japan. Am J Kidney Dis. 2013;61:197\u2013203.","journal-title":"Am J Kidney Dis"},{"key":"2853_CR4","doi-asserted-by":"publisher","first-page":"2473","DOI":"10.1056\/NEJMra054415","volume":"354","author":"LA Stevens","year":"2006","unstructured":"Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function\u2014measured and estimated glomerular filtration rate. N Engl J Med. 2006;354:2473\u201383.","journal-title":"N Engl J Med."},{"key":"2853_CR5","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1007\/s10157-011-0525-y","volume":"15","author":"M Horio","year":"2011","unstructured":"Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S. Performance of serum cystatin C versus serum creatinine as a marker of glomerular filtration rate as measured by inulin renal clearance. Clin Exp Nephrol. 2011;15:868\u201376.","journal-title":"Clin Exp Nephrol."},{"issue":"105","key":"2853_CR6","first-page":"S117","volume":"2024","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO","year":"2024","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO. clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;2024(105):S117-314.","journal-title":"Kidney Int."},{"key":"2853_CR7","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1056\/NEJMoa1214234","volume":"369","author":"MG Shlipak","year":"2013","unstructured":"Shlipak MG, Matsushita K, \u00c4rnl\u00f6v J, Inker LA, Katz R, Polkinghorne KR, et al. Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med. 2013;369:932\u201343.","journal-title":"N Engl J Med."},{"key":"2853_CR8","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1038\/s41591-019-0627-8","volume":"25","author":"JS Lees","year":"2019","unstructured":"Lees JS, Welsh CE, Celis-Morales CA, Mackay D, Lewsey J, Gray SR, et al. Glomerular filtration rate by differing measures, albuminuria and prediction of cardiovascular disease, mortality and end-stage kidney disease. Nat Med. 2019;25:1753\u201360.","journal-title":"Nat Med."},{"key":"2853_CR9","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1186\/s12882-017-0759-3","volume":"18","author":"H Legrand","year":"2017","unstructured":"Legrand H, Werner K, Christensson A, Pihlsg\u00e5rd M, Elmst\u00e5hl S. Prevalence and determinants of differences in cystatin C and creatinine-based estimated glomerular filtration rate in community-dwelling older adults: a cross-sectional study. 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