{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:21:06Z","timestamp":1761513666319},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with primary hyperparathyroidism (PHPT) are at risk of chronic kidney disease (CKD). Cystatin C (Cys-C) is considered a more reliable tool to assess glomerular filtration rate (GFR) than creatinine. The study aimed to assess circulating Cys-C and its relationships with biochemical PHPT and cardiometabolic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>The present cross-sectional study was performed in academic endocrine units on PHPT patients (<jats:italic>n<\/jats:italic>=190) and non-hypertensive, non-diabetic, age- and sex-matched healthy controls (<jats:italic>n<\/jats:italic>=135) with no established CKD. The main outcomes were creatinine by alkaline picrate method, Cys-C by immunonephelometry and calculation of estimated GFR based on creatinine and Cys-C (eGFRcr-cys) using the CKD-EPI equation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In PHPT patients, circulating Cys-C ranged 0.45\u20133.13\u200amg\/l and correlated with creatinine, age and BMI. Mean Cys-C level was higher in PHPT patients than in controls (0.93\u00b10.02 vs 0.78\u00b10.14\u200amg\/l;<jats:italic>P<\/jats:italic>=0.03). Cys-C levels in PHPT patients were predicted by age, BMI, ionized calcium, hypertension and HDL-cholesterol, the most significant determinant being ionized calcium. Cys-C positively correlated with cardiovascular disease (CVD) occurrence. Overall, 18.4% of PHPT patients with eGFRcr &gt;60\u200aml\/min per 1.73\u200am<jats:sup>2<\/jats:sup>(<jats:italic>n<\/jats:italic>=169) had Cys-C levels higher than the 95th percentile in controls (1.03\u200amg\/l), consistent with a preclinical CKD, which was associated with hypertension and insulin resistance. Considering eGFRcr-cys, CKD (stages G3a, G3b, 4) was diagnosed in 13.7% of PHPT patients. Estimated GFRcr-cys, but not eGFR based on creatinine, was predicted by insulin resistance and hypertension and positively correlated with CVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elevated Cys-C levels were associated with ionized calcium, cardiometabolic risk factors and CVD, and identified preclinical CKD in PHPT patients.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-15-0341","type":"journal-article","created":{"date-parts":[[2015,7,21]],"date-time":"2015-07-21T01:55:27Z","timestamp":1437443727000},"page":"441-446","update-policy":"http:\/\/dx.doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":11,"title":["Estimated glomerular filtration rate by serum cystatin C correlates with cardiometabolic parameters in patients with primary hyperparathyroidism"],"prefix":"10.1093","volume":"173","author":[{"given":"Federica","family":"Ermetici","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello","family":"Filopanti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uberta","family":"Verga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Passeri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgia","family":"Dito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis Elias","family":"Malavazos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Mapelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Elisabetta","family":"Raggi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Spada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Corbetta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"key":"2015082718040562000_173.4.441.1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0569"},{"key":"2015082718040562000_173.4.441.2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3708"},{"key":"2015082718040562000_173.4.441.3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0587"},{"key":"2015082718040562000_173.4.441.4","doi-asserted-by":"crossref","unstructured":"Yuoo N Donnan PT Flynn RW Murphy MJ Smith D Rudman A Leese GP . 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