ArticleJournal of the American Society of Nephrology : JASN2026
Medications Influencing Serum Cystatin C Independent of Measured GFR.
Article in Journal of the American Society of Nephrology : JASN, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Medication Effects on Cystatin C and the Interpretation of Kidney Function: Imperfect but Informative.Journal of the American Society of Nephrology : JASN · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
key pointsUse of glucocorticoids, opioids, and loop diuretics raised cystatin C independent of GFR. Except for glucocorticoids, cystatin C increases were small and likely clinically nonmeaningful. Consequently, the underestimation of eGFR cys was larger in medication users; combined eGFR cr-cys was most accurate.
backgroundSerum cystatin C is influenced by factors beyond GFR, and several medications have been hypothesized to alter its generation. Whether reported associations reflect effects on cystatin C independent of measured GFR (mGFR) or confounding by illness remains unclear.
methodsWe studied 5595 adults who underwent outpatient cystatin C (and creatinine) testing with mGFR determination using iohexol clearance in Stockholm health care. Associations between eight candidate medication classes and cystatin C were assessed using both interindividual and intraindividual analyses, sequentially adjusting for mGFR, clinical variables, and ongoing medications. We further evaluated the effect of these medications on cystatin C-based eGFR (eGFR cys ) bias compared with serum creatinine-based (eGFR cr ) and combined (eGFR cr-cys ) equations.
resultsAfter adjustment for mGFR and confounders, the use of systemic glucocorticoids, opioids, and loop diuretics was associated with higher cystatin C. The magnitude of increase was potentially clinically meaningful for glucocorticoid use, particularly for greater estimated daily dose categories, whereas the smaller increases observed with opioid and loop diuretic use likely reflect clinically nonmeaningful effects. No associations were observed for use of allopurinol, immunosuppressants, thyroid hormone analogues, or antipsychotics or for paracetamol after adjustment for concomitant medications. eGFR cys underestimated mGFR more in users than in nonusers, while eGFR cr overestimated mGFR similarly in users and nonusers. eGFR cr-cys provided the least biased GFR estimates.
conclusionsThis study suggests that systemic glucocorticoids, opioids, and loop diuretics may increase cystatin C independent of mGFR. The use of eGFR cr-cys was consistently more accurate than either eGFR cr or eGFR cys alone in patients using these treatments.
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