--- title: "Evidence: Cystatin C-based eGFR" description: "Lower kidney function and higher albuminuria are linked to increased risks of kidney failure, cardiovascular disease, and hospitalizations." url: "https://magellanlongevity.com/study/s157.md" canonical: "https://magellanlongevity.com/study/s157.html" html: "https://magellanlongevity.com/study/s157.html" type: "study" study_key: "s157" journal: "JAMA" year: 2023 pmid: "37787795" doi: "10.1001/jama.2023.17002" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Evidence: Cystatin C-based eGFR [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Evidence: Cystatin C-based eGFR **HTML version:** https://magellanlongevity.com/study/s157.html · **In the Magellan app:** https://magellanlongevity.com/#/study/s157 ## Citation | Field | Value | | --- | --- | | Journal | JAMA | | Year | 2023 | | PMID | [37787795](https://pubmed.ncbi.nlm.nih.gov/37787795/) | | DOI | [10.1001/jama.2023.17002](https://doi.org/10.1001/jama.2023.17002) | | Study key | s157 | ## Takeaway 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? ## Hypothesis 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. ## Methods 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. ## Results 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. ## Conclusion 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. ## Verbatim from the abstract > lower eGFR was associated with increased rates of adverse outcomes ## Hospitalization Rates by eGFR Category (UACR < 10 mg/g) | Measure | 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.* ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | Cystatin C / eGFR Kidney Test | Measurement tool | [Cystatin C / eGFR Kidney Test](https://magellanlongevity.com/p/157.md) | ## Reference 1. **Evidence: Cystatin C-based eGFR** JAMA 2023 · [PMID 37787795](https://pubmed.ncbi.nlm.nih.gov/37787795/) · [DOI 10.1001/jama.2023.17002](https://doi.org/10.1001/jama.2023.17002) > lower eGFR was associated with increased rates of adverse outcomes ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/s157.html#page","url":"https://magellanlongevity.com/study/s157.html","name":"Evidence: Cystatin C-based eGFR","description":"Lower kidney function and higher albuminuria are linked to increased risks of kidney failure, cardiovascular disease, and hospitalizations.","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/s157.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Evidence: Cystatin C-based eGFR","item":"https://magellanlongevity.com/study/s157.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/s157.html#study","name":"Evidence: Cystatin C-based eGFR","headline":"Evidence: Cystatin C-based eGFR","datePublished":"2023","isPartOf":{"@type":"Periodical","name":"JAMA"},"identifier":"PMID:37787795","url":"https://pubmed.ncbi.nlm.nih.gov/37787795/","sameAs":"https://doi.org/10.1001/jama.2023.17002","abstract":"Lower kidney function and higher albuminuria are linked to increased risks of kidney failure, cardiovascular disease, and hospitalizations."}]} ``` ## Related on Magellan Longevity - [Cystatin C / eGFR Kidney Test](https://magellanlongevity.com/p/157.md) — product graded on this and related evidence - [Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US…](https://magellanlongevity.com/study/d38597157.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).