{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T22:23:19Z","timestamp":1785363799350,"version":"3.55.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The creatinine-to-cystatin C ratio (Cr\/CysC) is a promising surrogate marker for muscle mass. While associated with adverse outcomes in various diseases, its prognostic utility for cardiorenal risks in the Chinese non-dialysis chronic kidney disease (CKD) population remains inadequately explored. This study aimed to investigate the association between the Cr\/CysC ratio and the risks of cardiovascular disease (CVD) and CKD progression in a large Chinese CKD cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 16,031 non-dialysis CKD patients from the China Renal Data System (CRDS). Cox proportional hazards models were used to assess the relationship between the serum Cr\/CysC ratio and the incidence of CVD and CKD progression over 28,189.68 person-years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In CKD patients, a higher serum Cr\/CysC ratio was significantly associated with lower risks of both CVD events and CKD progression. Compared to the lowest quartile (Q1), patients in the highest quartile (Q4) had a 21% lower risk of CVD (HR: 0.79, 95% CI: 0.67\u20130.92) and a 49% lower risk of CKD progression (HR: 0.51, 95% CI: 0.46\u20130.58). When analyzed as a continuous variable, each unit increase in the log-transformed ratio was associated with a significantly reduced risk for both outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A higher serum Cr\/CysC ratio is independently associated with reduced risks of CVD and CKD progression in Chinese patients with non-dialysis CKD. This ratio may serves as a useful prognostic marker for risk stratification in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1766312","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:23:02Z","timestamp":1773033782000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The creatinine-to-cystatin C ratio as a prognostic risk-stratification biomarker in chronic kidney disease"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaohong","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Ganzhou People's Hospital, Ganzhou Hospital-Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ganzhou People's Hospital, Ganzhou Hospital-Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licong","family":"Su","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney and Urological Diseases, Nanfang Hospital, State Key Laboratory of Multi-organ Injury Prevention and Treatment, Southern Medical University, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Institute of Nephrology","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meihua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ganzhou People's Hospital, Ganzhou Hospital-Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ganzhou People's Hospital, Ganzhou Hospital-Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney and Urological Diseases, Nanfang Hospital, State Key Laboratory of Multi-organ Injury Prevention and Treatment, Southern Medical University, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Institute of Nephrology","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ganzhou People's Hospital, Ganzhou Hospital-Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e382","DOI":"10.1016\/S2214-109X(23)00570-3","article-title":"An update on the global disparities in kidney disease burden and care across world countries and regions","volume":"12","author":"Bello","year":"2024","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1001\/jamainternmed.2022.6817","article-title":"Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance","volume":"183","author":"Wang","year":"2023","journal-title":"JAMA Intern Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1016\/j.kint.2024.12.017","article-title":"Executive summary 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