Kidney Test Mismatch Linked to Higher Risk of Disease and Death
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A new global study suggests that a mismatch between two routine blood tests used to assess kidney function may quietly signal elevated risks of kidney failure, heart disease, and death.
When two widely used tests of kidney function do not align, patients may face a greater risk of kidney failure, heart disease, and death. For many years, clinicians have relied on blood levels of creatinine to estimate how effectively the kidneys remove waste produced by muscle metabolism. More recent medical guidelines also recommend measuring cystatin C, a small protein produced by all cells in the body, as another indicator of kidney function.
As creatinine and cystatin C are affected by different biological factors, including illness and aging, evaluating both together can offer a more accurate picture of kidney health and the likelihood of organ failure than using either test on its own.
A gap that predicts future disease
Researchers from NYU Langone Health found that large differences between the two test results are common, particularly among people who are already unwell, and that these gaps may signal future health problems. In the international study, more than one-third of hospitalized participants showed cystatin C based estimates of kidney function that were at least 30 percent lower than estimates based on creatinine.
“Our findings highlight the importance of measuring both creatinine and cystatin C to gain a true understanding of how well the kidneys are working, particularly among older and sicker adults,” said study co-corresponding author Morgan Grams, MD, PhD. “Evaluating both biomarkers may identify far more people with poor kidney function, and earlier in the disease process, by covering the blind spots that go with either test.”
Why accurate kidney assessment matters
The study was recently published in the Journal of the American Medical Association and was presented at the American Society of Nephrology’s annual Kidney Week conference.
Accurate measurement of kidney function is not only essential for detecting disease but also for determining safe and effective doses of medications, including cancer treatments, antibiotics, and many commonly prescribed drugs, said Grams, the Susan and Morris Mark Professor of Medicine at the NYU Grossman School of Medicine.
In a separate study released on the same day, the research team reported that chronic kidney disease now affects more people worldwide than ever before and has become the ninth leading cause of death globally. Dr. Grams,who is also a professor in the Department of Population Health at NYU Grossman School of Medicine,said that improving methods for early detection could allow patients to begin treatment sooner and reduce the need for more intensive measures such as dialysis or organ transplantation.
Global data reveal long-term risks
For the recent investigation, the research team analyzed health care records, blood tests, and demographic data collected from 860,966 men and women of a half-dozen nationalities. All participants had their creatinine and cystatin C levels measured on the same day and received follow-ups 11 years later on average. The team considered factors unrelated to kidney function that influence the biomarkers’
New Genetic Insights into Chronic Kidney Disease Progression Published in JAMA
A large-scale genetic study published in JAMA on November 7, 2025, has identified new genetic variants associated with the progression of chronic kidney disease (CKD). The research, conducted by the Chronic Kidney Disease prognosis Consortium Investigators and Collaborators, offers potential new targets for the development of therapies to slow or prevent kidney failure. https://doi.org/10.1001/jama.2025.17578
The study involved a extensive analysis of genetic data from a diverse population, examining the relationship between specific genetic markers and the rate of kidney function decline. Researchers identified several novel genetic loci that significantly influence CKD progression, expanding upon previously known genetic risk factors.
The research team included Ih-Jen Hwang, Lesley A. Inker, Joachim H. Ix, Keiko Kabasawa, Tsuneo Konta, Jennifer S. Lees, Kevan R. Polkinghorne, Michael G. Shlipak, Robin W. M. Vernooij, David C. Wheeler, Ashok Kumar Yadav, Andrew S. Levey,Kai-Uwe Eckardt,Teresa K Chen,Yingying Sang,Morgan E Grams,Josef Coresh,Steven Chadban,Nisha Bansal,Marie Metzger,Benedicte Stengel,Martin Landray,John N Townend,Jonathan Emberson,Chi-yuan Hsu,Wei Yang,Amanda Anderson,Hermann Brenner,Dietrich Rothenbacher,Ben Schöttker,Hannah Stocker,Daniel Levy,Martin Larson,Anna Kottgen,Peggy Sekula,Ulla T Schultheiss,Markus P Schneider,Vivek Kumar,Manisha Sahay,Narayan Prasad,Katharine Cheung,Titi Ilori,Edouard L fu,anne-Laure Faucon,Aurora Caldinelli,Antoine Creon,Kazunobu Ichikawa,Satoru Nagase,Masafumi Watanabe,Patrick B Mark,Anders Larsson,Vilmantas Giedraitis,Yumi Ito,junta Tanaka,Ichiei Narita,Michelle Estrella,Shoshana H Ballew,Juan-Jesus Carrero,Ron T Gansevoort,Kunihiro Matsushita,Dorothea Nitsch,Angela Yee-Moon Wang,Carina M Flaherty and aditya Surapaneni.
The findings were presented at ASN Kidney Week. Funding for the study was provided by the National Institutes of Health (grant R01DK100446) and the National Kidney Foundation. https://www.nih.gov/ https://www.kidney.org/