Every year, World Kidney Day serves as a global reminder of the importance of kidney health. Chronic kidney disease (CKD) affects nearly 850 million people worldwide, yet it remains largely underdiagnosed until it reaches an advanced stage. Early detection helps slow progression, prevent complications and improve patient outcomes, emphasise the importance of early detection.

World Kidney day 2025 - Are Your Kidneys OK? Detect early, protect kidney health

World Kidney Day #WKD2025 takes place on March 13^th. The year-long campaign theme, “Are Your Kidneys OK? Detect Early, Protect Kidney Health,” highlights the potentially life-changing impact of early detection and intervention in preventing and managing kidney disease. 

Detecting kidney disease early with biomarkers

Early detection of kidney disease is crucial for slowing progression and improving patient outcomes. Glomerular Filtration Rate (GFR) is the best indicator of kidney function, measuring how much blood the kidneys filter per minute. Since direct GFR measurement is complex, an estimated GFR (eGFR) is calculated using biomarkers like cystatin C and creatinine.

Creatinine has been the most widely used for kidney assessment, but is affected by muscle mass, age, and diet, reducing its reliability for early detection. Cystatin C, by contrast, is produced at a stable rate and freely filtered by the kidneys, making it a sensitive and independent marker of kidney function.^1,2 When used together, cystatin C and creatinine provide a more precise and comprehensive evaluation of kidney health.

By identifying kidney dysfunction in its earliest stages, healthcare providers can intervene sooner with lifestyle modifications, medication adjustments, and close monitoring to slow CKD progression. Using cystatin C alongside creatinine in routine screenings improves diagnostic accuracy, particularly in high-risk populations such as older adults and individuals with low muscle mass.²

Cystatin C and creatinine: A more effective combination for early detection

Serum creatinine levels rise only after about 50% of lost renal function.³ This lack of sensitivity to mild renal insufficiency creates a "creatinine blind area" (30-70 ml/min/1.73 m²) that can lead to under diagnosis of CKD stages 1 and 2. Relying solely on creatinine for assessing kidney function may prevent the detection of renal diseases, potentially delaying critical early interventions.³

Combining creatinine and cystatin C values improves eGFR accuracy over using either marker alone.¹ This integration enhances risk stratification for CKD patients, facilitates better resource allocation, such as nephrology referrals, medication dosage adjustments, and more comprehensive kidney function tests.⁴

Research shows that GFR estimation equations that incorporate both cystatin C and creatinine provide a more precise assessment of kidney function than equations that use either marker alone.¹

Kidney health advocates and organisations embrace the benefits of cystatin C  

The global non-profit organisation Kidney Disease - Improving Global Outcomes (KDIGO) recommends using cystatin C in combination with creatinine to estimate GFR. This approach is particularly important for patients who are frail, at high risk of kidney disease complications, or require a more precise GFR assessment.

Similarly, the National Kidney Foundation (NKF) – American Society of Nephrology (ASN) Task Force supports the use of cystatin C alongside creatinine to improve the accuracy of kidney function evaluation (link). Their recommendations emphasize the importance of integrating cystatin C into routine clinical practice, particularly for patients where creatinine-based estimates may be less reliable, ensuring better risk assessment and treatment decisions for individuals with or at risk of CKD.

Gentian Cystatin C Immunoassay - available on most automated clinical chemistry platforms

Gentian's cystatin C immunoassay is applied to turbidimetry-based clinical chemistry platforms. It is an open channel assay, meaning it can be added to all clinical chemistry analysers.

• FDA 510(k) cleared since 2008
• CE-marked and IVDR-certified
• Developed and manufactured by Gentian
• Avian antibodies - gives less interference
• Manufactured in Norway and according to ISO 13485:2016

References:

1. Hsu CY et al. Race, Genetic Ancestry, and Estimating Kidney Function in CKD. N Engl J Med. 2021
2. Ebert N et al. Cystatin C is ready for clinical use. Curr Opin Nephrol Hypertens, 2020
3. Schaeffner E et al. Two novel equations to estimate kidney function in persons aged 70 years or older. Ann Intern Med. 2012
4. Murty MS et al. Serum cystatin C as a marker of renal function in detection of early acute kidney injury. Indian J Nephrol. 2013
   
   

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