Kim H, Park JT, Lee J, et al. - Patients with chronic kidney disease (CKD) were noted to be at a higher risk of major adverse cardiovascular events (MACE) and faster coronary artery calcification (CAC) progression in presence of a large positive difference between creatinine-based estimated glomerular filtration rate (eGFRcreat) and cystatin C-based estimated glomerular filtration rate (eGFRcys). Patients with a higher estimated glomerular filtration rate difference (eGFRdiff; calculated by subtracting the eGFRcys from the eGFRcreat should be carefully monitored for cardiovascular disease.

• Prospective cohort study in 2,076 patients with CKD stages.

• One hundred forty-seven patients had occurrence of MACE during a median follow-up of 4.1 years, (incidence rate, 15.0 per 1,000 patient-years).

• When patients were categorized into baseline eGFRdiff tertiles, a significantly higher risk of MACE was observed in correlation with the highest tertile relative to the lowest tertile.

• More baseline coronary artery calcification (CAC) was recorded in patients in the highest tertile vs those in the lowest tertile.

• Significant association of baseline eGFRdiff with accelerated CAC progression (≥ 50/year) was evident.