Cystatin C As A Measure Of Kidney Function
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- Опубліковано 4 вер 2023
- How is Cystatin C different from creatinine? Which should you have measured if you have kidney disease?
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Sean Hashmi, MD, MS, FASN
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Michele Crosmer, RD CSR
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The information provided on this channel is for educational purposes only, and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment.
excellent explanation, many thanks
I’ve been hoping for this video for a while! Thank you very much Dr Hashmi! 🙏🏻
My pleasure!
Love the information. I have been followed since age 42 for CKD, but working in an office setting and not really working out regularly. Then I quit work at 66 and started working out hard, every day, bike, swim, elliptical, force exercises, etc.... I could feel myself get stronger, what took 4 hours was taking 2-3 hours and started increasing reps. Well my GFR started to drop fast, my nephrologist freaked out even though I told him about my workout routine. He rand a (serology ?) blood test nothing. Also had a botched biopsy (that hurt), and I may have to re-do that one. I went on vacation for 3 months and didn't do any exercise other than hike up a mountain in France (about 1.2-1.3 km elevation change). When I got back my GFR improved 3 or 4 points.
I wish there was a test that did direct measurement for kidney function (Injection of substance and measurement of output over time?). The only thing that changed in my life was upping my exercise. I don't ever see old guys doing what I was doing in the gym, and most young people don't do what I was doing. Kind of frustrated about the inferred measurement because so many variables can change the outputs.
Great info with one exception. Losing kidney function with age isn't guaranteed. Three years ago at age 63, I was told I was 3 years from needing dialysis with an eGFR of 54 and several years of rapid decline (and I had heart failure). Three years later (today), I have an eGFR of 84, and all other heart and kidney markers are normal. I've helped many people do what I did, and it's worked for them as well. For the record, and not trying to be rude, but it was not a plant-based diet. Cheers
Please, help us here!
so, can you Help please.
Thank you.
@@cougar1861 Both heart and kidney failure are interconnected. I was diagnosed with both and told it was irreparable even though I'd eaten a healthy plant-focused diet all my life. The problem was I'd become pre-diabetic and had high fasting insulin because of glycemic carbs! Adopting a high fat, moderate protein, very low carb healthy keto diet, intermittent fasting, and other interventions effectively cured both. I'm fit, healthy, and taking zero medications. I wrote about how and my guide has been shared around the world. Hundreds have reported to me great benefit. For some reason, Google won't allow me to post the latest updated version of my PKD (CKD) Treatment Guide. You can find it in this comment thread if you want. Scroll around a bit. Hope it helps. Cheers
@@TheCristal63 Both heart and kidney failure are interconnected. I was diagnosed with both and told it was irreparable even though I'd eaten a healthy plant-focused diet all my life. The problem was I'd become pre-diabetic and had high fasting insulin because of glycemic carbs! Adopting a high fat, moderate protein, very low carb healthy keto diet, intermittent fasting, and other interventions effectively cured both. I'm fit, healthy, and taking zero medications. I wrote about how and my guide has been shared around the world. Hundreds have reported to me great benefit. For some reason, Google won't allow me to post the latest updated version of my PKD (CKD) Treatment Guide. You can find it in this comment thread if you want. Scroll around a bit. Hope it helps. Cheers
What was it that you were doing?
This great information. Makes sense to watch for a change.
He started off strong but I still don’t really understand the relative utility of cystatin C. I think people want to know what even is cystatin C (its native function), why it was researched, why it has been presented as a racially less biased metric (?), how creatinine and cystatin are actually used together, etc. I think people understand that trending labs is important; I didn’t click this video to learn that
I demand that my pcp and neph run a cystatin-c during blood workups.....and they always relent after giving me the stink eye. All they care about is creatinine, but my cystatin-C eGFR runs about 30 points higher. Yes, 30 pts. So I use the combined formula since I don't have any confounding issues for cystatin-C. I'm 65 years old, 5'6", and 140lbs. Compared to most my age, I have way more muscle mass. In fact, I've got 6 pack abs. That's why I prefer looking at the cystatin-c number. It makes me feel better about my kidneys. :D Fyi, my creatinine eGFR is in the low 50's and my cystatin-c eGFR is in the mid-80's. Combined, I'm around 70 eGFR.
You need to do urine test..if no protein leaking or your ACR ratio below 30...you no need to worry...
Im a bodybuilding and my creatinine is 1.3 -1.52 and GFR is 60 -75...but my cystatin C is 0.96 and GFR is 95...no other symptomps and i doing ultrasound of my kidney,all is normal and good..
But now i try to reduce my protein intake..
Just had my blood work and urinalysis done again this week. Creatinine is up to 1.59 (eGFR 48) and cystatin-c is at .91. (eGFR 86). There is no protein leakage, so that is a good thing. I'm in my mid-60's, so not good, but also not the end of the world. I'm not a body builder per se, but I'm cut. @@edwardwidjaya9730
@@edwardwidjaya9730 GFR is 60-75 or 95?
@@DaveThomson that is two kind of eGFR...from crratinine and from Cystatine C..
@@edwardwidjaya9730 okay thanks
This test isn't available on the nhs. My egfr has hovered around 35/40 for 5 months now dropped from 80. It's dropped as low as 11. My creatine has also been as high as 300 but currently at 261. Not on any meds or supplements. Had symptoms on and off such a blood in urine, hair loss etc. I eat well, have exercised my entire life etc. Specialist said a biopsy wouldn't show anything and basically I've been left with no answers but having booked even week to monitor. Any advice?
My creatinine is 1.12 ans cystatin c is 1.23. My case is almost opposite of what other patients are saying.
My creatinine is almost stable for 1 year now or even more.
Just last July 2023 I had an egfr of 46 and creatin level of 1.38. I was seen by my nephrologist and he told me that with my numbers, I’m have the most good numbers he saw for that day as a patient. He put me on a 24 hours urine test and prescribed me Potassium Citrate 30 meq twice a day after getting my results. September 11 I got my labs again. My egfr is now 35 and my creatinine is 1.68. Potassium level are at normal range. I’m a diabetic with an A1C of 6.7. I’m already walking for 30 minutes everyday, eating lots of vegetables, minimizing my carbs intake and it’s frustrating that I’m still not well on my numbers. I’m seeing a nephrologist also aside from my GP. I eliminated nsaids, metformin etc and drink 85-90 ounces of water everyday. There must be something that is not being address on my conditions by the 2 doctors I’m seeing. Please advice. I will really appreciate hearing from you.
Your gluocse is too high! Get a CGM and wear it for two weeks and you'll see whats raising your blood glucose. Increase your walking to 1 hour from 30 minutes. Set a goal of 5-6000 steps a day at first, then increase it with a goal of 10k steps a day average. Eventually get it to 15-20k steps a day. 8 hours of walking per week is more effective than the full daily dose of metformin at improving insulin sensitivity.
Additionaly start lifting weights 2 to 3 times a week.
Glucose is high, follow the other comments wonderful advice!
Plant based kidney health is an oxymoron. High carbs and oxalate poisoning.
Fact checked: True!
We recommend high fiber and lower carb to fiber ratio. Not a high refined carb/sugar diet. And you should definitely check out our multiple videos on oxalates and kidney health! We have a recent on from last week that does into depth about oxalates and kidney disease/health.
Comparison of Estimated Glomerular Filtration Rate by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Equations with and without Cystatin C for Predicting Clinical Outcomes in Elderly Women
Found:
eGFR derived from CKD-EPI cystatin C and CKD-EPI creatinine-cystatin C equations did not improve the accuracy or predictive ability for clinical events compared to CKD-EPI-creatinine
At 66yo, my eGFR/createnine was 85, my eGFR/cystatin-c also 85. I added 5g creatine daily (+ CrossFit) my eGFR/createnine dropped to 59 however eGFR/cystatin-c stayed at 85. I’m stopping creatine for 4 weeks to “double double check”. Whole FOMO ituation made worse by 1 blood test that showed a slightly higher potassium (back to normal on subsequent).
I am 44 years male , Indian Origin living in Australia, Regular Gym goer , My Creatinine is 1.74 mg/DL ( EGFR = 47 ml/min/1.73m2) based on which I was told Stage 3 CKD. I go to gym 6 days a week and eat high protein diet so I almost forced my Doctor to do a Cystatine C test EGFR and guess what my Cystatine C is 0.77 mg/L ( EGFR 113 ml/min/1.73m2) .
Doctor was really angry ....Go figure
YOU MUST UNDERSTAND THIS
YOU ARE A CUSTOMER
They get paid to "manage" your care
cystatin test will set you free
order the test yourself
Is there any advice to prolong dialysis in pkd patients? I'm at 16% functioning, and started a vegan diet after getting those results. I was 24% functioning last year.
I have some advice, if you want. I've helped 100s with CKD and numerous people get off dialysis. I'm giving you my treatment guide (free). Hope it helps. For the record, I've yet to see a vegan do well recovering kidney function (too many carbs and too much insulin). I explain why in more detail in the guide. Cheers
docs.google.com/document/d/14hVT-455l63T5VSZH5fYS80pyvWAvCTQIqTmzIcMxug
We have a couple episodes you can check out on PKD! Also, highly recommend checking out www.kidneynutritioninstitute.org. They are a group of expert PKD Renal Dietitians! --Michele Crosmer
@@PlantBasedKidneyHealth Thank you. I've seen all of your posted videos. Not trying to be rude, but many years of your plant-based diet is what got me into trouble, but I look at all concepts for useful information, not so much for my own benefit, but for the people I help. I've worked with Jess Saville, and I refer to her in the treatment guide I posted, and I'm a frequent contributor on her Facebook Group page along with Dr. Weimbs and others. I've yet to see a vegan/vegetarian get off dialysis or have great improvement. The best they see is what the medical books tell them, PKD causes steady and progressive failure. I know better now and am trying to spread the word to those who are interested. Best wishes.
My cystine c is 0.91