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Biomarkers

Cystatin C

An accurate marker of kidney function, independent of muscle mass

Cystatin C — a marker of the kidneys' glomerular filtration

Cystatin C is a small protein that all body cells produce at a steady rate and the kidneys fully filter. It is a modern, accurate marker of kidney function.

Its main advantage over creatinine: cystatin C hardly depends on muscle mass, sex or diet. So in the elderly, in athletes and in people of non-standard build it estimates GFR more reliably.

Reference ranges

Approximate reference for adults:

Adults0.5 – 1.0 mg/L
Advantageindependent of muscle and diet
Useto calculate eGFR from cystatin C
Important: The normal range differs slightly between labs and rises with age. eGFR is calculated from cystatin C (or a combination with creatinine) — often more accurately than the "creatinine" formula, especially in borderline cases.

What an elevated level means

A high cystatin C means a decline in the kidneys' filtration function — and, unlike creatinine, this now depends little on muscle or diet, so the signal is "cleaner".

The causes are the same as for a reduced eGFR: chronic kidney disease, diabetic and hypertensive nephropathy, acute kidney injury.

The level is slightly affected by thyroid function, inflammation and high-dose corticosteroids.

What a low level means

A low cystatin C is a favorable sign of good kidney filtration and usually needs no attention.

How the test is done

Venous blood. It needs no special preparation — another way in which it is more convenient than creatinine, which is affected by meat and workouts.

Cystatin C is especially useful when the "creatinine" eGFR is in doubt: in the elderly, in athletes, and with very low or very high muscle mass.

What affects the value

  • Kidney function — the main and almost the only significant factor.
  • Age — the level rises slightly over the years.
  • Thyroid gland — marked disorders have a small effect.
  • High-dose corticosteroids — can raise it.
  • Muscle mass — unlike creatinine, its effect is minimal.

Calculate using this marker

Calculators where Cystatin C is used directly:

Frequently asked questions

Is cystatin C better than creatinine?

In many cases — yes, it estimates GFR more accurately because it does not depend on muscle mass, sex or diet. It is especially useful in the elderly, in athletes and in people of non-standard build, where creatinine is deceptive. They are often used together.

Is any preparation needed for the test?

Practically none — unlike creatinine, cystatin C is not affected by a meat meal or workouts. A venous blood draw is enough.

When should cystatin C be tested?

When the creatinine-based eGFR is in doubt: in the elderly, in people with very high or very low muscle mass, in athletes, and for a more accurate assessment of kidney function over time.

Related terms

Sources

  1. MedlinePlus (NIH) — Cystatin C Test
  2. NIDDK (NIH) — Estimating Glomerular Filtration Rate
info
This content is educational and does not replace consultation with a physician. Reference ranges may vary depending on the laboratory and method — rely on the ranges stated on your own test report.
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