Kidney Week

Abstract: TH-PO1026

Intraindividual Difference between Cystatin C- and Creatinine-Based eGFR Is Associated with All-Cause and Cardiovascular Mortality: The Fukuoka Kidney disease Registry (FKR) Study

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Kitamura, Hiromasa, Fukuoka Shika Daigaku, Fukuoka, Japan

Hiromasa Kitamura, MD, PhD

• Tanaka, Shigeru, Fukuoka Shika Daigaku, Fukuoka, Japan

Shigeru Tanaka, MD, PhD

• Hiyamuta, Hiroto, Shakai Iryo Hojin Seitetsu Kinen Yawata Byoin, Kitakyushu, Fukuoka, Japan

Hiroto Hiyamuta, MD, PhD

• Ooboshi, Hiroaki, Fukuoka Shika Daigaku, Fukuoka, Japan

Hiroaki Ooboshi, MD, PhD

• Tsuruya, Kazuhiko, Nara Kenritsu Ika Daigaku, Kashihara, Nara, Japan

Kazuhiko Tsuruya, MD, PhD

• Kitazono, Takanari, Kyushu Daigaku, Fukuoka, Fukuoka, Japan

Takanari Kitazono, MD, PhD

• Nakano, Toshiaki, Kyushu Daigaku, Fukuoka, Fukuoka, Japan

Toshiaki Nakano, MD, PhD

Background

Estimated glomerular filtration rate (eGFR) based on serum creatinine (eGFRcr) and serum cystatin C (eGFRcys) are widely used to evaluate kidney function in patients with chronic kidney disease (CKD). Discrepancies between these measurements are not uncommon and have been linked to adverse outcomes such as death and cardiovascular events. Despite this, research on these discrepancies and their association with outcomes in Japanese patients with CKD is limited, highlighting a major gap in the collective understanding within this community.

Methods

We examined 4,244 patients with non-dialysis-dependent CKD who participated in the Fukuoka Kidney disease Registry (FKR) Study, a multicenter prospective cohort study. Patients were categorized into three groups based on eGFRdiff (calculated as eGFRcys − eGFRcr, mL/min/1.73m²): G1 (<0), G2 (0–10), and G3 (>10). The associations between eGFRdiff and both all-cause and cardiovascular mortality were investigated using Cox proportional hazards models.

Results

During the 5-year follow-up period, 418 patients (9.8%) died from all causes, and 101 patients (2.4%) died from cardiovascular causes. Compared to G3, the multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for all-cause mortality were 2.67 (1.98–3.59) for G1 and 1.71 (1.25–2.33) for G2. For cardiovascular mortality, the HRs (95% CIs) were 2.48 (1.38–4.46) for G1 and 1.20 (0.63–2.30) for G2.

Conclusion

Lower eGFRdiff values are associated with poor outcomes in terms of both all-cause and cardiovascular mortality in patients with non-dialysis-dependent CKD.