Update on Cystatin C – It’s Time to Change Your Practice – BCR PWR (April 4, 2025) скачать в хорошем качестве

Update on Cystatin C – It’s Time to Change Your Practice – BCR PWR (April 4, 2025)

Dr. Michael Shlipak presents his talk, “Update on Cystatin C – It’s Time to Change Your Practice,” as part of BC Renal and UBC’s province-wide rounds. 0:05:00 – Cystatin C Advantages Dr. Shlipak begins by talking about how there has been increasing interest in cystatin C (CysC) in recent years, resulting in updated 2024 KDIGO guidelines. Whereas interest was once focused a lot of creatinine to measure kidney function, he notes that creatinine can be misleading (e.g., many factors can affected creatinine, including medications, weightlifting, diet, hospitalization, etc). In contrast, cystatin C is affected by fewer factors (e.g., high/low cell turnover, steroid therapy, smoking, obesity). 0:13:00 – Accuracy of Equations Dr. Shlipak provides overviews of different equations using cystatin C, noting that these outperform equations that use creatinine; however, the most accurate equations use a combo of both. 0:15:00 – CysC Guidelines He says that although eGFR is the gold standard, it’s actually imprecise. Dr. Shlipak highlights his research over the years showing how cystatin C is effective for defining “normal” kidney function, and is even indicative of heart health. He notes that 2024 KDIGO guidelines have been updated to include cystatin C, and delves into these guidelines in more detail. 0:24:00 – CysC Testing in the Clinic Dr. Shlipak notes that the U.S. Veteran Affairs is leading efforts to adopt cystatin C into practice across the country, by increasing its # of CysC tests, and other health care systems are following suit. He discusses the costs of adopting cystatin C testing. 0:28:00 – eGFR differences Dr. Shlipak talks about differences between eGFRcys and eGFRcr, and how it relates to chronic kidney disease (CKD) outcomes. He highlights data on what factors predict large differences between eGFRcys and eGFRcr, including race, age, sex, meat intake, grip strength, smoking, etc). 0:38:00 – Creatinine in the ICU Next, Dr. Shlipak points to a study showing how patients’ creatinine levels decline over time while they are in the intensive care unit. He notes that, as a result, cystatin C is a better option for monitoring patients. 0:41:00 – Case studies He provides four case examples of patients under different scenarios. 0:50:00 – Summary and Q&A Dr. Shlipak provides a summary of his talk before taking questions from the audience.