Systematic Survey of Creatinine-Based Versus Cystatin C-based Estimated GFR in People with Diabetes

Abstract

Background: Diabetes is a common cause of kidney failure, and most anti-diabetic agents are excreted through the kidneys. Therefore, it is critical to adjust medication dosage and anti-diabetic agents based on kidney function. There are different methods to estimate kidney function, but the common practice is to use creatinine to estimate the glomerular filtration rate. Objective: In this systematic review, we identify and review publications in order to assess differences between creatinine-based and cystatin C-based estimated glomerular filtration rates in diabetic patients. Method: The articles were identified using 3 databases and were assessed for eligibility. A total of 4 articles were included. Comparisons of the 2 patient groups as well as the patient characteristics were compiled into 2 tables. Results: Two studies showed significant differences between creatinine-based and cystatin C-based estimated glomerular filtration rates in patients with type 1 diabetes. There were no significant differences in control or type 2 diabetes groups. Conclusions: Although cystatin C-based estimation of kidney function looks promising, it fails to show superiority over creatinine-based estimation. Most studies included in this systematic review, however, had serious limitations to them. Further research with standardized ways of measuring creatinine and cystatin C is required.