Non-GFR determinants of creatinine and cystatin C
Increase serum creatinine concentration |
Muscle mass |
Protein intake |
Rhabdomyolysis |
Increase serum cystatin C |
Male |
Older age |
Obesity |
Smoking |
Hyperthyroidism (hypothyroidism decreases it) |
Glucocorticoid therapy |
Inflammatory markers (C-reactive protein) |
Malignancy |
Consider ordering serum cystatin C GFR |
In patients at the extremes of muscle mass or cachexia |
When the serum creatinine concentration is elevated without urinary or radiologic evidence of kidney damage |
When a more precise GFR measurement will change treatment decisions |
GFR = glomerular filtration rate