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Objectives <p>The impact of the difference between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFRdiff) on hypertension remains unknown. We investigated the association of eGFRdiff and the risk of developing hypertension.</p> Methods <p>A total of 3628 participants without hypertension at baseline in 2011 from the China Health and Retirement Longitudinal Study were enrolled. The eGFRdiff was calculated using both absolute difference (eGFRabdiff = eGFRcys–eGFRcr) and the ratio (eGFRrediff = eGFRcys/eGFRcr) between cystatin C- and creatinine-based estimated glomerular filtration rate. The association between eGFRdiff and hypertension risk was examined using restricted cubic spline (RCS) and multivariable logistic regression analysis.</p> Results <p>The mean (± SD) for eGFRabdiff and eGFRrediff were −&#xa0;16.3 ± 16.5&#xa0;mL/min/1.73&#xa0;m<sup>2</sup>, and 0.83 ± 0.17, respectively. During 4&#xa0;years of follow-up, 605 incident hypertension cases were identified. Participants in the third quantile of eGFRabdiff&#xa0;had a lower risk of hypertension than participants in the first quantile of eGFRabdiff (OR 0.72, 95% CI 0.57–0.92,<i> P</i> = 0.01), adjusting for potential confounders.&#xa0;RCS showed an inversely linear relationship between eGFRabdiff&#xa0;and hypertension risk. In the fully adjusted model, each standard deviation increase in eGFRabdiff&#xa0;was associated with a 0.85-fold decrease in the risk of incident hypertension (OR 0.85, 95% CI 0.77–0.94, <i>P</i> = 0.002). Sensitivity analysis also confirmed the results. In exploratory analyses, the proportional effect of eGFRabdiff on hypertension risk was consistent across the six pre-specified subgroups (all <i>P</i> for interaction &gt; 0.05). Similar results were observed for eGFRrediff.</p> Conclusions <p>A large negative difference in cystatin C-based and creatinine-based eGFR was significantly associated with the risk of hypertension. Our findings suggested that monitoring eGFRdiff could be clinically useful in identifying high-risk people for hypertension.</p>

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Difference between estimated glomerular filtration rate based on cystatin c versus creatinine and risk of hypertension: a prospective cohort study

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  • 发表日期：

    2025年8月4日

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  • Yue Song,
  • Changqiang Yang

摘要

Objectives

The impact of the difference between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFRdiff) on hypertension remains unknown. We investigated the association of eGFRdiff and the risk of developing hypertension.

Methods

A total of 3628 participants without hypertension at baseline in 2011 from the China Health and Retirement Longitudinal Study were enrolled. The eGFRdiff was calculated using both absolute difference (eGFRabdiff = eGFRcys–eGFRcr) and the ratio (eGFRrediff = eGFRcys/eGFRcr) between cystatin C- and creatinine-based estimated glomerular filtration rate. The association between eGFRdiff and hypertension risk was examined using restricted cubic spline (RCS) and multivariable logistic regression analysis.

Results

The mean (± SD) for eGFRabdiff and eGFRrediff were − 16.3 ± 16.5 mL/min/1.73 m2, and 0.83 ± 0.17, respectively. During 4 years of follow-up, 605 incident hypertension cases were identified. Participants in the third quantile of eGFRabdiff had a lower risk of hypertension than participants in the first quantile of eGFRabdiff (OR 0.72, 95% CI 0.57–0.92, P = 0.01), adjusting for potential confounders. RCS showed an inversely linear relationship between eGFRabdiff and hypertension risk. In the fully adjusted model, each standard deviation increase in eGFRabdiff was associated with a 0.85-fold decrease in the risk of incident hypertension (OR 0.85, 95% CI 0.77–0.94, P = 0.002). Sensitivity analysis also confirmed the results. In exploratory analyses, the proportional effect of eGFRabdiff on hypertension risk was consistent across the six pre-specified subgroups (all P for interaction > 0.05). Similar results were observed for eGFRrediff.

Conclusions

A large negative difference in cystatin C-based and creatinine-based eGFR was significantly associated with the risk of hypertension. Our findings suggested that monitoring eGFRdiff could be clinically useful in identifying high-risk people for hypertension.