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Heart & Vascular Health

Blood Testing for Cystatin C (with eGFR)

Cystatin C is a small protein that all your body’s cells release into the bloodstream at a steady rate (cysteine protease inhibitor made by nucleated cells). The kidneys filter it out through the glomeruli, and the filtered protein is then taken up and broken down by the tubules, so it doesn’t return to the blood. At home blood testing is available in select states. See FAQs below

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Key Benefits

  • Check how well your kidneys filter, beyond muscle size, with cystatin C–based eGFR.
  • Spot early kidney decline when creatinine seems normal, improving timely chronic kidney disease detection.
  • Clarify chronic kidney disease stage and risk to trigger specialist referral when indicated.
  • Guide safer drug dosing and contrast imaging decisions that depend on accurate filtration.
  • Flag higher heart risk linked to reduced kidney function measured with cystatin C.
  • Explain confusing results when muscle loss, high fitness, or liver disease skew creatinine.
  • Track kidney trends over time to monitor progression, stability, or recovery after illness.
  • Best interpreted with a urine albumin-to-creatinine ratio and blood pressure.

What is a Cystatin C (with eGFR) blood test?

Cystatin C is a small protein that all your body’s cells release into the bloodstream at a steady rate (cysteine protease inhibitor made by nucleated cells). The kidneys filter it out through the glomeruli, and the filtered protein is then taken up and broken down by the tubules, so it doesn’t return to the blood. A Cystatin C blood test measures this protein and reports an estimated kidney filtering value (eGFR, estimated glomerular filtration rate) calculated from the cystatin C level.

Because production is steady and removal depends almost entirely on kidney filtration, blood cystatin C reflects how well your kidneys are filtering. Reporting eGFR alongside it translates that signal into an intuitive estimate of overall kidney filtering capacity (glomerular filtration rate). Compared with creatinine, cystatin C is less tied to muscle mass and typical diet, making it helpful across different ages and body types. In practice, it provides a clear, complementary view of kidney function and helps track changes over time.

Why is a Cystatin C (with eGFR) blood test important?

Cystatin C is a small protein made by all cells and cleared almost entirely by the kidneys’ filters. Measured together with the estimated glomerular filtration rate (eGFR), it gives a clear picture of how well your kidneys are cleansing the blood—affecting blood pressure, fluid balance, electrolytes, bone and red blood cell health, toxin and drug removal, and ultimately heart and brain function. Unlike creatinine, cystatin C is minimally influenced by muscle mass, diet, or sex, making it reliable across ages and body types.

Typical cystatin C values sit in a narrow lab range; better kidney function shows values toward the lower end, with eGFR in the higher range. eGFR tends to be higher in children and during normal pregnancy, and it declines gradually with aging.

When cystatin C is low and eGFR is high, filtration is brisk. People usually feel well. This pattern is common in children and pregnancy, and can also reflect “hyperfiltration” states (for example, early diabetes or high cardiac output) that may precede later kidney strain.

When cystatin C is high and eGFR is low, filtration is reduced. Waste and fluid accumulate, contributing to fatigue, swelling, shortness of breath, high blood pressure, nighttime urination, and foamy urine. Chronic reductions disrupt bone–mineral balance, erythropoietin and hemoglobin (anemia), and nerve function. In kids, long-standing impairment can affect growth; in pregnancy, cystatin C can rise despite increased GFR, so context matters.

Big picture: cystatin C with eGFR anchors kidney health to the cardiovascular and endocrine systems, refines chronic kidney disease staging beyond creatinine, and signals long-term risks for heart disease, stroke, and mortality even with mild declines in filtration.

What insights will I get?

Cystatin C (with eGFR) measures a small protein made by all cells that is freely filtered by the kidney’s glomeruli and metabolized in the tubules. Its blood level reflects how well the kidneys are filtering (glomerular filtration rate, GFR). Because kidneys regulate fluid, electrolytes, acid–base balance, blood pressure, erythropoietin, and vitamin D, cystatin C links directly to energy production, cardiovascular stability, cognition, immune function, and reproductive health.

Low values usually reflect higher filtration (hyperfiltration) or lower cystatin C production rather than disease. They can appear in early pregnancy and with too little thyroid hormone (hypothyroidism). Unlike creatinine, low muscle mass does not falsely lower cystatin C.

Being in range suggests stable GFR and effective clearance of metabolic wastes, with steady electrolytes and blood pressure control. For most adults, values toward the lower end of the reference interval indicate robust filtration, appropriate for age and body size.

High values usually reflect reduced GFR from acute or chronic kidney impairment, signaling slower toxin clearance, fluid and electrolyte shifts, and higher cardiovascular risk. Levels can also rise independent of GFR with systemic inflammation, glucocorticoid exposure, obesity, smoking, and too much thyroid hormone (hyperthyroidism). Cystatin C tends to increase with age as filtration declines; in pregnancy, elevations may indicate complications that reduce GFR.

Notes: Cystatin C–based eGFR is less affected by muscle mass and does not require race adjustment. Equations that combine cystatin C with creatinine improve accuracy. Acute illness, assay differences, and medications (especially steroids and thyroid therapies) influence interpretation; correlate with creatinine, urinalysis, and clinical context.

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Frequently Asked Questions About

What is cystatin C and why is it important for kidney function testing?

Cystatin C is a small protein produced at a steady rate by nearly all nucleated cells in the body. It is freely filtered by the kidneys’ glomeruli and almost entirely cleared from the blood through this process. Because its production is consistent and not significantly affected by muscle mass, diet, or body size, cystatin C serves as a reliable marker for kidney filtration efficiency. Measuring cystatin C, especially when used to calculate estimated glomerular filtration rate (eGFR), provides a more accurate assessment of kidney function, particularly in individuals where creatinine-based tests may be unreliable.

How does cystatin C–based eGFR differ from creatinine-based eGFR?

Cystatin C–based eGFR offers a more muscle-independent estimate of kidney function compared to creatinine-based eGFR. While creatinine levels can be influenced by muscle mass, diet, age, and sex, cystatin C is less affected by these factors. This makes cystatin C–based eGFR especially useful for older adults, children, and people with unusually high or low muscle mass. It provides a clearer picture of true kidney filtration capacity, helping to clarify kidney function when creatinine results are borderline or uncertain.

When should a cystatin C test be used instead of or alongside creatinine?

A cystatin C test is particularly valuable when creatinine-based eGFR results are borderline (e.g., 45–59 mL/min/1.73m²), or when muscle mass, age, or diet may make creatinine unreliable. It is also useful for confirming or ruling out chronic kidney disease, guiding medication dosing for drugs cleared by the kidneys, and assessing cardiovascular risk. Combining cystatin C with creatinine and urine albumin tests provides a more comprehensive view of kidney health.

What are the benefits of using cystatin C to assess kidney function?

Using cystatin C to assess kidney function offers several benefits: it provides a more accurate estimate of glomerular filtration rate (eGFR) independent of muscle mass, body size, or diet; it helps clarify kidney function in special populations like children and older adults; it improves chronic kidney disease staging; and it enables safer medication dosing. Additionally, cystatin C levels are linked to cardiovascular risk, allowing for earlier prevention and intervention.

How is cystatin C measured and what does “with eGFR” mean?

Cystatin C is measured through a simple blood test. The result is often used to calculate an estimated glomerular filtration rate (eGFR), which quantifies how well the kidneys are filtering blood. “With eGFR” means the cystatin C value is incorporated into a standardized formula to estimate overall kidney filtering capacity, providing a single, interpretable number that reflects kidney health.

What states are Superpower’s at-home blood testing available in?

Superpower currently offers at-home blood testing in the following states: Alabama, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin.

We’re actively expanding nationwide, with new states being added regularly. If your state isn’t listed yet, stay tuned.

Can cystatin C levels be affected by factors other than kidney function?

Yes, cystatin C levels can be influenced by factors such as age, thyroid status (higher in hyperthyroidism, lower in hypothyroidism), systemic inflammation, corticosteroid use, pregnancy, and higher body fat. However, these influences are generally less significant than those affecting creatinine. It is important to interpret cystatin C results in the context of these factors and, when possible, compare results from the same laboratory.

Why is cystatin C–based eGFR especially useful in older adults and children?

Cystatin C–based eGFR is particularly useful in older adults and children because it is less affected by variations in muscle mass and body size, which can skew creatinine-based estimates. In children, cystatin C helps track true kidney filtration as their bodies grow and develop. In older adults, it provides a more accurate assessment of kidney function, as muscle mass naturally declines with age, making creatinine less reliable.

How does cystatin C testing help with medication dosing and cardiovascular risk assessment?

Cystatin C testing refines the estimation of kidney function, which is crucial for dosing medications that are cleared by the kidneys. Accurate eGFR calculations help prevent under- or overdosing, reducing the risk of side effects or toxicity. Additionally, elevated cystatin C levels are associated with higher cardiovascular risk, so testing can flag individuals who may benefit from earlier cardiovascular prevention strategies.

What are common misconceptions about cystatin C and eGFR testing?

A common misconception is that cystatin C is only useful for diagnosing kidney disease. In reality, it provides a broader view of kidney health, cardiovascular risk, and medication safety. Another misconception is that cystatin C is completely unaffected by non-renal factors; while it is less influenced than creatinine, factors like thyroid status, inflammation, and pregnancy can still impact levels. Finally, some believe cystatin C–based eGFR is only needed when creatinine is abnormal, but it can add value even when creatinine is within the normal range, especially in special populations.

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