{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:01:22Z","timestamp":1792155682802,"version":"4.4.0"},"reference-count":20,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"crossref","award":["NN-2026-003"],"award-info":[{"award-number":["NN-2026-003"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Medical Research Register","award":["RSCH ID-25-03258-ROB"],"award-info":[{"award-number":["RSCH ID-25-03258-ROB"]}]},{"name":"Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Chronic kidney disease (CKD) is a progressive disease in which accurate estimation of glomerular filtration rate (GFR) is essential for staging and guiding therapy. Serum creatinine is widely used but influenced by non-renal factors, while cystatin C and \u03b22-microglobulin (\u03b22M) may provide complementary information related to filtration and tubular or inflammatory factors. This study compared the discriminatory performance of creatinine, cystatin C and \u03b22M for separating CKD stage 3 from stage 4 within the 2021 CKD-EPI eGFR framework in 45 adults with CKD stages 3\u20134. CKD stage classification was defined using the 2021 CKD-EPI creatinine and creatinine\u2013cystatin C equations (eGFRcr, eGFRcr\u2013cys) with a threshold of 30 mL\/min\/1.73 m2. Receiver operating characteristic (ROC) analysis evaluated each marker\u2019s ability to distinguish moderate from severe CKD. Creatinine showed high diagnostic accuracy (AUC up to 0.98). Cystatin C achieved 100% specificity at the optimal cut-off for severe CKD and showed comparable diagnostic accuracy to creatinine under the eGFRcr\u2013cys framework (AUC 0.978 vs. 0.957). \u03b22M demonstrated AUCs up to 0.97, with sensitivity and specificity above 90%. These findings support a multi-marker evaluation within the 2021 CKD-EPI-based staging, rather than validation against measured GFR. Larger studies incorporating measured GFR and relevant clinical confounders are warranted.<\/jats:p>","DOI":"10.3390\/ijms27020862","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:26:36Z","timestamp":1768465596000},"page":"862","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multi-Marker Evaluation of Creatinine, Cystatin C and \u03b22-Microglobulin for GFR Estimation in Stage 3\u20134 CKD Using the 2021 CKD-EPI Equations"],"prefix":"10.3390","volume":"27","author":[{"given":"Nurulamin","family":"Abu Bakar","sequence":"first","affiliation":[{"name":"Centre of Diagnostics, Therapeutics and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3157-8819","authenticated-orcid":false,"given":"Nurul Izzati","family":"Hamzan","sequence":"additional","affiliation":[{"name":"Special Protein Unit, Specialized Diagnostic Centre, Institute for Medical Research, National Institutes of Health, Jalan Pahang, Kuala Lumpur 50588, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2800-4188","authenticated-orcid":false,"given":"Siti Nurwani","family":"Ahmad Ridzuan","sequence":"additional","affiliation":[{"name":"Special Protein Unit, Specialized Diagnostic Centre, Institute for Medical Research, National Institutes of Health, Jalan Pahang, Kuala Lumpur 50588, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-766X","authenticated-orcid":false,"given":"Izatus Shima","family":"Taib","sequence":"additional","affiliation":[{"name":"Centre of Diagnostics, Therapeutics and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zariyantey","family":"Abdul Hamid","sequence":"additional","affiliation":[{"name":"Centre of Diagnostics, Therapeutics and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5529-5115","authenticated-orcid":false,"given":"Anasufiza","family":"Habib","sequence":"additional","affiliation":[{"name":"Specialized Diagnostic Centre, Institute for Medical Research, National Institutes of Health, Jalan Pahang, Kuala Lumpur 50588, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9805-4412","authenticated-orcid":false,"given":"Noor Hafizah","family":"Hassan","sequence":"additional","affiliation":[{"name":"Special Protein Unit, Specialized Diagnostic Centre, Institute for Medical Research, National Institutes of Health, Jalan Pahang, Kuala Lumpur 50588, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Saminathan, T.A., Hooi, L.S., Mohd Yusoff, M.F., Ong, L.M., Bavanandan, S., Rodzlan Hasani, W.S., Tan, E.Z.Z., Wong, I., Rifin, H.M., and Robert, T.G. 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