Creatinine Versus Cystatin C: Differing Estimates of Renal Function in Hospitalized Veterans Receiving Anticoagulants 1,2 3 1 Christina Hao Wang, MD , Anna D. Rubinsky, PhD , Tracy Minichiello, MD , 1,2,3,4 1,2 Michael G. Shlipak, MD, MPH , and Erika Leemann Price, MD, MPH 1 2 San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco (UCSF), 3 4 San Francisco, CA, USA; Kidney Health Research Collaborative, UCSF and SFVAMC, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, UCSF, San Francisco, CA, USA. patients were reclassified into lower drug-dosing catego- BACKGROUND: Current practice in anticoagulation dos- ries using cystatin C compared to creatinine-based ing relies on kidney function estimated by serum creati- estimates. nine using the Cockcroft-Gault equation. However, creat- CONCLUSIONS: We found substantial discordance in inine can be unreliable in patients with low or high muscle eGFR comparing cystatin C with creatinine in this group mass. Cystatin C provides an alternative estimation of of anticoagulated inpatients. Our sample size was limited glomerular filtration rate (eGFR) that is independent of and included few women. Further investigation is needed muscle. to confirm these findings and evaluate implications for OBJECTIVE: We
Journal of General Internal Medicine – Springer Journals
Published: May 31, 2018
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