From the Guidelines
To reduce cystatin C levels, focus on improving kidney function through lifestyle modifications and managing underlying conditions, as cystatin C is primarily a marker of kidney filtration capacity, and consider medications like ACE inhibitors or ARBs as prescribed by your doctor, as supported by the most recent and highest quality study 1.
Key Lifestyle Modifications
- Maintain good hydration by drinking 2-3 liters of water daily
- Follow a kidney-friendly diet low in sodium (under 2,300 mg daily), moderate in protein (0.8g per kg of body weight), and rich in fruits and vegetables
- Regular exercise of at least 150 minutes per week of moderate activity can improve overall kidney health
Managing Underlying Conditions
- Manage diabetes (maintain HbA1c below 7%) and hypertension (keep blood pressure under 130/80 mmHg) with appropriate medications as prescribed by your doctor
- Avoid nephrotoxic substances including NSAIDs (like ibuprofen), certain antibiotics, and excessive alcohol
Medications for Kidney Protection
- If you have chronic kidney disease, medications like ACE inhibitors or ARBs may be prescribed to protect kidney function, as they have been shown to reduce the risk of kidney failure and cardiovascular events 1
Additional Considerations
- Weight loss if overweight and smoking cessation are also beneficial for overall kidney health
- These approaches work because they reduce inflammation and oxidative stress that can damage kidneys, thereby potentially lowering cystatin C levels which rise when kidney filtration declines
- Regular monitoring of kidney function, including cystatin C levels, and urinary protein levels is advised, especially in individuals with underlying conditions like tuberous sclerosis complex 1
From the Research
Reducing Cystatin C Levels
To reduce Cystatin C levels, it is essential to understand the factors that affect its levels. Cystatin C is a marker of kidney function, and its levels can be influenced by various physiological and pathophysiological conditions 2.
Factors Affecting Cystatin C Levels
Some of the factors that can affect Cystatin C levels include:
- Thyroid dysfunction
- Glucocorticoids use
- Malignancies
- Muscle mass and protein intake do not affect Cystatin C levels, unlike creatinine 2
- Cystatin C levels can be higher in diabetic patients, even when albuminuria and eGFR do not indicate chronic kidney disease 3
Reducing Cystatin C Levels
While there is no direct evidence on how to reduce Cystatin C levels, maintaining good kidney function and addressing underlying conditions that may affect kidney function can help. This can include:
- Managing diabetes and other conditions that may affect kidney function
- Maintaining a healthy lifestyle, including a balanced diet and regular exercise
- Avoiding medications that can harm kidney function, such as certain antibiotics and pain medications
Clinical Considerations
Cystatin C has been shown to be a reliable and accurate marker of kidney function across diverse populations 4. It can be used to estimate kidney function, diagnose chronic kidney disease, and risk-stratify patients for adverse outcomes. However, its use in clinical practice has limitations, and clinicians should be aware of these limitations when interpreting Cystatin C levels 4.
Prognostic Importance of Cystatin C
Cystatin C has prognostic importance for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease 5. Elevated Cystatin C levels can indicate a "preclinical" state of kidney dysfunction that is not detected with serum creatinine or estimated GFR 5.
Key Points
- Cystatin C is a marker of kidney function that can be affected by various physiological and pathophysiological conditions
- Maintaining good kidney function and addressing underlying conditions can help reduce Cystatin C levels
- Cystatin C has prognostic importance for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease
- Clinicians should be aware of the limitations of Cystatin C when interpreting its levels 2, 6, 3, 4, 5