Differences between cystatin C- and creatinine-based estimated glomerular filtration rate and the risks of postoperative complications and mortality

doi:10.1016/j.jclinane.2026.112185

Perioperative medicine & outcomes

Differences between cystatin C- and creatinine-based estimated glomerular filtration rate and the risks of postoperative complications and mortality

J Clin AnesthPublished 25 Mar 2026Prospective cohort study

Read the original article ↗PubMed

Cite

Authors' conclusion

A highly negative eGFR difference was independently associated with increased risks of postoperative complications and mortality.

Study context

Population: UK Biobank participants with baseline serum creatinine and cystatin C who had surgery within 1 year of recruitmentprimary analysis
Participants: 26,065 participants

Exposure: Highly negative estimated glomerular filtration rate (eGFR) difference vs neutral
Outcome: Postoperative complications (30-day) and all-cause mortality (90-day)
Follow-up: 30-day complications; 90-day mortality

Methodological detailsUK Biobank, restricted cubic spline modeling, sensitivity and subgroup analyses

UK Biobank
Restricted cubic spline modeling
Sensitivity and subgroup analyses

Main finding

As reported in the abstract

Postoperative complications and mortality

Each group vs neutral eGFR differenceEstimate (95% CI)P value

Highly negative eGFR difference

OR (complications, fully adjusted) 1.60(1.28–2.01)

P < 0.001

Highly negative eGFR difference

OR (mortality, fully adjusted) 1.96(1.27–3.00)

P = 0.002

Highly negative eGFR difference

OR (complications, unadjusted) 1.69(1.38–2.08)

P < 0.001

Highly negative eGFR difference

OR (mortality, unadjusted) 2.29(1.59–3.32)

P < 0.001

Observational data: associations, not effects.

Further findings

30-day postoperative complications and 90-day all-cause mortality, unadjusted models

Unadjusted models

Complications and mortality, extended analyses of participants having major surgery during follow-up

Complications: OR 1.23 (95% CI 1.17 to 1.30): P < 0.001
Mortality: OR 1.50 (95% CI 1.39 to 1.63): P < 0.001

Similar associations to primary analysis

Complications and mortality, fully adjusted models including cystatin C-based instead of creatinine-based eGFR (sensitivity analysis)

Complications: OR 1.36 (95% CI 1.07-1.73): P = 0.01
Mortality: OR 1.22 (95% CI 0.79-1.89): P = 0.37

Associations attenuated

Original publication

Differences between cystatin C- and creatinine-based estimated glomerular filtration rate and the risks of postoperative complications and mortality. J Clin Anesth. Published 25 March 2026. doi:10.1016/j.jclinane.2026.112185

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →