Creatinine-cystatin C discordance: An overlooked gap in modern nephrology-insights from a homeopathic lens

Evaluation of kidney function is central to nephrology, yet routine clinical practice continues to rely predominantly on serum creatinine for estimation of glomerular filtration rate (eGFR) [1]. Although creatinine is inexpensive and widely available, it is influenced by several non-renal factors including muscle mass, age, sex, diet, and protein metabolism [2]. Cystatin C is a low-molecular-weight protein (~13 kDa) that is freely filtered by the glomeruli and is less affected by muscle mass, providing a more accurate or complementary estimate of GFR [3]. Despite substantial evidence and recommendations from international guidelines such as KDIGO 2024, cystatin C remains underutilized in routine nephrology practice [4]. This article reviews creatinine-cystatin C discordance, explores reasons for underuse of cystatin C, and presents a homeopathic perspective emphasizing individualized patient assessment. Exclusive reliance on creatinine may lead to misclassification of chronic kidney disease (CKD), unnecessary anxiety, and premature disease labeling [5].