What are the associations of lower eGFR (based on creatinine alone or combined with cystatin C) and more severe albuminuria with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes?
Cystatin C / eGFR Kidney Test, a meta-analysis in 27,503,140 individuals (JAMA 2023, PMID 37787795) — for example, among individuals with UACR less than 10 mg/g, an eGFR of 45 to 59 mL/min/1.73 m2 based on creatinine alone was associated with significantly higher hospitalization rates compared to an eGFR of 90 to 104 mL/min/1.73 m2. Scope: 27,503,140 individuals, and the abstract states no limitations.
Source: JAMA 2023, PMID 37787795 ↗ · Research map · How Magellan grades evidence · evidence confidence: medium
JAMA · 2023 · PMID 37787795 · DOI 10.1001/jama.2023.17002
Lower kidney function and higher albuminuria are linked to increased risks of kidney failure, cardiovascular disease, and hospitalizations.
The question
What are the associations of lower eGFR (based on creatinine alone or combined with cystatin C) and more severe albuminuria with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes?
What they tested
Lower eGFR based on creatinine alone, lower eGFR based on creatinine combined with cystatin C, and more severe albuminuria will be associated with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes.
How they did it
This was an individual-participant data meta-analysis of 114 global cohorts from 1980 to 2021. The study included 27,503,140 individuals for eGFR based on creatinine alone, 720,736 individuals for eGFR based on creatinine and cystatin C, and 9,067,753 individuals for albuminuria. eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration 2021 equations, and albuminuria was estimated as urine albumin to creatinine ratio (UACR). The risks of 10 adverse outcomes were analyzed within each cohort and summarized with random-effects meta-analyses.
What they found
Lower eGFR (whether based on creatinine alone or based on creatinine and cystatin C) and higher UACR were each significantly associated with a higher risk for all 10 adverse outcomes, even in the mildest categories of chronic kidney disease. For example, among individuals with UACR less than 10 mg/g, an eGFR of 45 to 59 mL/min/1.73 m2 based on creatinine alone was associated with significantly higher hospitalization rates compared to an eGFR of 90 to 104 mL/min/1.73 m2. This represented an adjusted hazard ratio of 1.3 and an excess absolute risk of 22 events per 1000 person-years.
| eGFR 90-104 mL/min/1.73 m2 | 79 | |
|---|---|---|
| eGFR 45-59 mL/min/1.73 m2 | 161 |
Among people with a UACR less than 10 mg/g, hospitalization rates were higher for those with lower eGFR based on creatinine alone.
What it means
Lower eGFR, whether based on creatinine alone or combined with cystatin C, and more severe UACR are each associated with increased rates of adverse kidney outcomes, cardiovascular diseases, and hospitalizations.
Limitations
The abstract does not explicitly state limitations of the study.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Magellan’s evidence label | Cystatin C-based eGFR (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | JAMA |
| Year | 2023 |
| PMID | 37787795 ↗ |
| DOI | 10.1001/jama.2023.17002 ↗ |
| Topic | General aging biology & healthspan |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Cystatin C / eGFR Kidney Test
Across large cohorts and meta-analyses, cystatin C-based eGFR is at least as accurate as creatinine-based eGFR and is more strongly associated with death, cardiovascular events, and end-stage kidney disease—in one ~90,750-person consortium meta-analysis it markedly improved risk reclassification for death—and it…
Cystatin C is a low-molecular-weight protein produced at a nearly constant rate by all nucleated cells…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What are the associations of lower eGFR (based on creatinine alone or combined with cystatin C) and more severe albuminuria with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes? [Plain-English summary of JAMA 2023, PMID 37787795, DOI 10.1001/jama.2023.17002]. Magellan Longevity. https://magellanlongevity.com/study/s157.html@misc{magellan_s157,
title = {What are the associations of lower eGFR (based on creatinine alone or combined with cystatin C) and more severe albuminuria with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s157.html}},
note = {Plain-English summary of PubMed PMID 37787795; DOI 10.1001/jama.2023.17002; JAMA 2023. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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