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

Abstract

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. 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. 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. 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. 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.