EKFC Cystatin C (2023)

Adult2023

European sex-free and race-free equation using cystatin C only

Calculate EKFC CysC

Enter the values required by this equation to estimate the result.

Enter all required values to see the result.

For educational and clinical reference use. Interpret results in clinical context.

Formula

eGFR=107.3×(ScysC/Q)α×{1if age400.990age40if age>40\text{eGFR} = 107.3 \times (S_{cysC}/Q)^{\alpha} \times \begin{cases} 1 & \text{if age} \leq 40 \\ 0.990^{\text{age}-40} & \text{if age} > 40 \end{cases}

Formula constants

SymbolDescriptionValue
107.3Base coefficient
QQMedian serum cystatin C reference
Age ≤ 50:0.83mg/L
Age > 50:0.83 + 0.005 × (age − 50)mg/L
α\alphaExponent (depends on SCysC/Q ratio)
SCysC/Q < 1:−0.322
SCysC/Q ≥ 1:−1.132
Age factorAge correction applied only when age > 40
Age ≤ 40:1 (no correction)
Age > 40:0.990^(age − 40)
ScysCS_{cysC}inputSerum cystatin Cmg/L
AgeinputPatient ageyears

Required inputs

AgeCystatin C

Validated age range

18 to 120 years

Limitations

  • Requires standardized cystatin C assay (ERM-DA471/IFCC)
  • No pediatric cohorts in the validation study (all patients ≥18 years)
  • More expensive than creatinine-based equations
  • Cystatin C may be affected by thyroid dysfunction, inflammation, and corticosteroids

Clinical notes

  • Sex-free AND race-free equation
  • Uses only age and cystatin C (no sex factor needed)
  • Q rescaling factor derived without race or sex terms (Q = 0.83 mg/L; age-adjusted after 50)
  • Less affected by muscle mass than creatinine equations
  • Validated in adult European, American, and African cohorts (all ≥18 years)

References

  • [1]Pottel H, Björk J, Rule AD, et al. Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex. N Engl J Med. 2023;388(4):333-343. doi:10.1056/NEJMoa2203769
  • [2]Delanaye P, Cavalier E, Pottel H, Stehlé T. New and old GFR equations: a European perspective. Clin Kidney J. 2023;16(9):1375-1383. doi:10.1093/ckj/sfad039

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