# Multimorbiditeit verhoogt kans op discrepantie tussen creatinine- en cystatine-C-eGFR

*geplaatst 2026-10-18 · Nierziekte · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · doi 10.1093/ndt/gfag232 · https://hartvaat.nl/2026/10/10/multimorbiditeit-verhoogt-kans-op-discrepantie-tussen-creatinine-en-cystatine-c-/*

Een analyse van meer dan 400.000 deelnemers van de UK Biobank toont aan dat de aanwezigheid van twee of meer chronische aandoeningen (multimorbiditeit) de kans op een grote discrepantie tussen creatinine- en cystatine-C-gebaseerd eGFR aanzienlijk verhoogt. Patiënten met vier of meer aandoeningen hadden een 4,6 keer hoger risico op een cystatine-C-eGFR dat meer dan 30% lager uitviel dan het creatinine-eGFR, wat leidde tot herschikking naar een ernstiger CKD-stadium bij 15% van de cohort. Deze bevindingen ondersteunen het gebruik van cystatine-C-bepalingen naast creatinine bij multimoride patiënten om de nierfunctie nauwkeuriger in te schatten en het risicoprofiel te verfijnen.

## English: Association between multimorbidity and discordance between creatinine- and cystatin C-based eGFR.

An analysis of over 400,000 UK Biobank participants demonstrates that multimorbidity (two or more long-term conditions) significantly increases the likelihood of substantial discordance between creatinine- and cystatin C-based eGFR. Patients with four or more conditions had a 4.6-fold higher odds of a cystatin C eGFR more than 30% lower than the creatinine eGFR, resulting in reclassification to a more advanced CKD stage for 15% of the cohort. These findings support incorporating cystatin C testing alongside creatinine in multimorbid patients to refine kidney function estimation and improve cardiovascular and renal risk stratification.

## Abstract (original, from the publication)

BACKGROUND AND HYPOTHESIS: Large differences between glomerular filtration rate estimated with creatinine and cystatin C-termed eGFR discordance-have important implications for health. Several demographic factors and individual long-term conditions (LTCs) are associated with eGFR discordance. We hypothesise that the presence of multiple LTCs i.e. multimorbidity is likely to be associated with eGFR discordance. METHODS: Differences between creatinine-based and cystatin C-based eGFR (eGFRcr and eGFRcys, respectively) using European Kidney Function Consortium equations were calculated in over 400 000 UK Biobank participants. Large negative eGFR difference was defined as an eGFRcys more than 30% lower than eGFRcr i.e. ([eGFRcys - eGFRcr]/eGFRcr) <-30%. Self-reported LTCs were counted and analysed overall and by type of multimorbidity (cardiometabolic, non-cardiometabolic, mixed mental and physical). Proportions of participants with large negative eGFR differences were cross-tabulated at different chronic kidney disease (CKD) stages and according to number of LTCs. The association between number of LTCs and eGFR discordance was assessed in logistic regression models adjusted for age, sex, body mass index, smoking status and thyroid disease. RESULTS: Multimorbidity (two or more LTCs of any type) was observed in 33% of the overall cohort and 63% of those with large negative eGFR differences. When CKD stage was assigned based on eGFRcr and then reassigned using eGFRcys, 15% of the cohort were reclassified to a more advanced CKD stage with frequency of reclassification increasing progressively with increasing counts of LTCs. Individuals with four or more LTCs of any type were more than four-fold more likely to have a large negative eGFR difference (adjusted odds ratio 4.64, 95% confidence interval 4.13-5.21) compared to individuals with no LTCs. CONCLUSION: Discordance between creatinine-based and cystatin C-based eGFR increased substantially with multimorbidity. Cystatin C testing should be considered (alongside creatinine) in individuals with multimorbidity to refine estimation of kidney function and risk stratification.

Auteurs: Kaitlin J Mayne, Heather Walker, Michael K Sullivan, Bhautesh Jani, Paul Welsh, Qiaoling Liu, Jill P Pell, Frederick K Ho, Patrick B Mark, Jennifer S Lees

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Bron: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, https://doi.org/10.1093/ndt/gfag232. Bijgewerkt 2026-10-12T01:02:30Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.