How to understand the association between cystatin C levels and cardiovascular disease: Imbalance, counterbalance, or consequence?

The association of cystatin C with renal function has been studied for more than 25 years. Cystatin C has been described to have a better diagnostic performance than creatinine to assess renal function, particularly to detect small reductions in glomerular filtration rate. Recently, cystatin C has emerged as a strong predictor of incident or recurrent cardiovascular events and adverse outcomes in patients without kidney disease.

Cystatin C, kidney function, and cardiovascular risk factors in primary hypertension.

Objective: To investigate the clinical usefulness of serum cystatin C (Scys) and cystatin C-based equations for the screening of chronic kidney disease in primary hypertensive patients, and correlate these markers with risk factors for cardiovascular disease.

Methods: A cross-sectional study was performed in 199 middle-aged adults at a basic health unit. Kidney function assessment included measurements of serum creatinine (Scr) and Scys levels, 24-hour microalbuminuria (MA), as well as glomerular filtration rate (GFR) through Larsson and Modification of Diet in Renal Disease (MDRD) study equations.