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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.
Accurate estimation of glomerular filtration rate (eGFR) is essential for diagnosing, staging, and managing chronic kidney disease (CKD). Creatinine-based eGFR (eGFRcr) is widely used but influenced by muscle mass, diet, and body composition, limiting its reliability in individuals with atypical physiology or early renal dysfunction. Cystatin C, a filtration marker unaffected by these factors, offers improved precision and prognostic value, particularly in the mid-range GFR (45–59 mL/min/1.73 m²). The combined CKD-EPI creatinine–cystatin C equation (eGFRcr-cys) provides the most accurate estimates and refines risk stratification. Although KDIGO and NICE recommend cystatin C testing when eGFRcr is unreliable, adoption remains low—especially in resource-limited settings. Discordance between eGFRcr and eGFRcys is frequent, emphasizing the need for real-world data from diverse populations. This study compares eGFRcr, eGFRcys, and eGFRcr-cys among consecutive patients tested in routine clinical practice in Kenya.
We retrospectively analyzed 693 consecutive patients who had simultaneous serum creatinine and cystatin C measurements at a central referral laboratory in Kenya over nine months. eGFR was calculated using CKD-EPI 2009 (eGFRcr), CKD-EPI 2012 cystatin C (eGFRcys), and CKD-EPI 2012 combined creatinine–cystatin C (eGFRcr-cys) equations. CKD stages (G1–G5) were assigned for each method, and inter-method discordance in CKD staging was determined, including the direction (upgrading or downgrading) and distribution across CKD stages.
Of the 693 patients (mean age 48 years; 53% male), CKD stage distribution varied by method:
eGFRcr: G1 57%, G2 28%, G3a 7%, G3b 4%, G4 2%, G5 1%
eGFRcys: G1 51%, G2 39%, G3a 6%, G3b 3%, G4 0%, G5 1%
eGFRcr-cys: G1 64%, G2 27%, G3a 4%, G3b 3%, G4 1%, G5 1%
Discordance in CKD staging occurred in 38% between eGFRcr and eGFRcys (n = 263), 28% between eGFRcr and eGFRcr-cys (n = 193), and 16% between eGFRcys and eGFRcr-cys (n = 112). The greatest discordance occurred in early CKD stages—G1 (22%) and G2 (12%). Compared with eGFRcr, eGFRcys upgraded CKD stage in 18.9% and downgraded in 16.2% of cases; eGFRcr-cys upgraded in 7.4% and downgraded in 17.5%. eGFRcr-cys vs eGFRcys showed minimal upgrading (0.2%) but downgraded in 11.7% of cases. Overlapping discordance across methods occurred in 26% of patients.
In routine clinical practice, eGFRcr and eGFRcys frequently yield discordant CKD staging (38%), particularly in early disease (G1–G2), reflecting the influence of non-renal factors on creatinine. The combined eGFRcr-cys equation substantially reduces discordance—especially relative to eGFRcys (16%)—and predominantly downgrades staging compared with eGFRcr (17.5%), suggesting overestimation of CKD severity by creatinine alone. These findings support the selective use of cystatin C and the preferential adoption of the combined CKD-EPI equation in ambiguous or borderline cases to enhance diagnostic accuracy, risk stratification, and clinical decision-making in diverse and resource-limited populations such as in Africa.
