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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Rheumatoid arthritis (RA) is a systemic autoimmune disease whose chronic inflammation affects not only joints but also, via immune complex deposition, vasculitis and sustained inflammatory mediator activation, the kidneys—significantly increasing the risk of renal dysfunction. Subclinical renal impairment, defined by reduced glomerular filtration rate (GFR) without proteinuria or clinical symptoms, marks a key transitional stage toward chronic kidney disease (CKD). Serum cystatin C (Cys C) is considered a more sensitive marker of glomerular filtration than creatinine, because its production is stable and unaffected by age, sex or muscle mass. Recent evidence suggests its levels may also be influenced by RA disease activity. This study uses a systematic review and meta-analysis to examine associations between serum Cys C, subclinical renal impairment and disease activity in RA patients.
We systematically searched PubMed, Embase, Web of Science and the Cochrane Library through October 2025, using keywords including “rheumatoid arthritis,” “cystatin C,” “glomerular filtration rate” and “disease activity.” We included observational studies meeting ACR/EULAR criteria that reported mean ± SD of serum Cys C stratified by renal function (eGFR) or disease activity (DAS28). Two reviewers independently screened literature, extracted data and assessed bias using the Newcastle-Ottawa Scale (NOS); discrepancies were resolved by discussion or third-party adjudication. For studies that reported Pearson correlations without CIs, Fisher’s Z transformation was applied based on sample size. We pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) using the meta package in R, selecting random- or fixed-effects models based on heterogeneity (I² > 50% indicating substantial heterogeneity). Sensitivity analyses tested result robustness.
A total of seven studies involving 8,998 RA patients were included. All studies scored ≥ 6 points on the NOS, indicating good methodological quality (Table 1). Meta-analysis revealed that, compared with RA patients with normal renal function, those with renal impairment (Figure 1) had significantly higher serum Cys C levels (five studies; SMD = 2.26, 95% CI: 1.09–3.43), although substantial heterogeneity was observed (I² = 97.3%). Likewise, compared with patients with low disease activity, those with high disease activity (Figure 2) exhibited significantly elevated serum Cys C levels (three studies; SMD = 0.80, 95% CI: 0.45–1.14), with moderate heterogeneity (I² = 38.6%). Sensitivity analyses confirmed the robustness of the pooled estimates.
This study demonstrates that in patients with rheumatoid arthritis, serum cystatin C levels are significantly positively correlated with both renal impairment and disease activity. These findings suggest that Cys C serves not only as a sensitive biomarker for renal function but may also reflect systemic inflammatory status in RA. Clinicians should therefore interpret Cys C values in RA patients by considering both renal function and disease activity. Future high-quality prospective studies are warranted to validate the predictive value of Cys C in RA-related renal injury and to elucidate the underlying mechanisms linking Cys C with inflammation regulation.
