Secondary analysis
Importance of cystatin C in estimating glomerular filtration rate: the PARADIGM-HF trial
- Secondary analysis of the PARADIGM-HF randomised trial
Authors' conclusion
The CKD-EPI creatinine-only equation may overestimate GFR in sicker patients.
Study context
- Population
- PARADIGM-HF subpopulation with HF and cystatin C and creatinine available at randomization
- Participants
- 1,966 participants
- Comparison
- CKD-EPI creatinine-cystatin C vs creatinine-only eGFR equation
Primary result
As reported in the abstract
eGFR, creatinine-cystatin vs creatinine-only CKD-EPI equation · at randomization
Median (IQR) eGFR difference, creatinine-cystatin minus creatinine
−0.7 (−6.4-4.8) mL/min/1.73 m²
Reallocated to a better eGFR category
212 (11%)
Reallocated to a worse eGFR category
355 (18%)
Further findings
Mortality by eGFR-difference group
- Group 1 vs Group 2: higher mortality
- Group 3 vs Group 2: lower mortality
Biomarkers (incl. NT-proBNP, troponin) and KCCQ clinical summary score
- Increasing eGFR difference (lower with creatinine-cystatin) associated with higher biomarkers and worse KCCQ clinical summary score
- Equations diverged with increasing HF severity because creatinine did not rise as steeply as cystatin C
Original publication
Importance of cystatin C in estimating glomerular filtration rate: the PARADIGM-HF trial. Eur Heart J. Published 13 April 2023. doi:10.1093/eurheartj/ehad210
Summarised from the published abstract; every number is checked against it