Iddo Z. Ben-Dov, MD, MSc
Potential Financial Conflicts of Interest: None disclosed.
Ben-Dov I.; Why Choose Serum Cystatin C Levels over Serum Creatinine Levels as a Serologic Marker of Kidney Function?. Ann Intern Med. 2008;149:284. doi: 10.7326/0003-4819-149-4-200808190-00016
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Published: Ann Intern Med. 2008;149(4):284.
TO THE EDITOR:
In their recent article, Kestenbaum and colleagues (1) reported that the incidence of hypertension in individuals without evident kidney disease is associated with variations in kidney function assessed by cystatin C levels. This implicates covert kidney dysfunction in the pathogenesis of hypertension. I wish to address issues concerning surrogates of clinical disease.
The authors excluded participants with overt kidney disease, defined by reduced creatinine level–based estimated glomerular filtration rate (GFR). However the outcome analyses were conducted by using serum cystatin C levels. Would the results materially differ if serum creatinine levels or estimated GFR rates had been used? If not, what is the added value of obtaining cystatin C levels?
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