ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
Association Between the Difference in Cystatin C and 1 Creatinine-Based eGFR and Risks of Multiple Cardiovascular 2 Diseases: A Prospective Cohort Study
Provisionally accepted
- Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
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Background: The difference between cystatin Cand creatinine-based estimated glomerular 23 filtration rate (eGFRdiff) is closely associated with various adverse outcomes. This study aims 24 to comprehensively evaluate the association between eGFRdiff, all-cause mortality, and the 25 risk of multiple cardiovascular-related diseases. 26 Methods: This study analyzed data from 297,140 participants in the UK Biobank to assess 27 the association between eGFRdiff, mortality, and the incidence of multiple 28 cardiovascular-related diseases. eGFRdiff was classified into three groups: negative (< -15 29 mL/min/1.73m²), intermediate (-15 to 15 mL/min/1.73m²), and positive (≥ 15 30 mL/min/1.73m²). Cox proportional hazards regression models were used to evaluate this 31 association, while various sensitivity analyses were performed to assess its robustness. 32 Results: During a mean follow-up of 13.1 years, the positive eGFRdiff group exhibited 33 significantly lower mortality, cardiovascular disease (CVD) incidence, and the occurrence of 34 CVD-related conditions. In the fully adjusted model, participants in the negative eGFRdiff 35 group had a hazard ratio of 1.44 (95% confidence interval [CI], 1.40–1.49) for all-cause 36 mortality, 1.49 (95% CI, 1.41–1.59) for CVD incidence, and 1.25 (95% CI, 1.22–1.27) for 37 CVD mortality. The risk of all ten CVD-related conditions was also significantly higher in the 38 negative group, whereas the positive group exhibited significantly lower risks. For every 10 39 mL/min/1.73 m² increase in eGFRdiff, the incidence of various diseases decreased by 40 approximately 10%-19%. 41 Conclusions: eGFRdiff is significantly associated with increased risks of mortality, CVD 42 incidence, and multiple CVD-related conditions. These findings underscore the critical need 43 for developing targeted prevention strategies, particularly for populations with reduced 44 eGFRdiff.
Keywords: Estimated glomerular filtration rate, serum creatinine, Cystatin C, cardiovascular disease, All-cause mortality
Received: 21 Jul 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Qiao, Liu, Liu, Chen, Li, Ge, Hu and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xinyi Liu, 2337544250@qq.com
Junming Zhu, anzhenzjm@ccmu.edu.cn
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