Assays traceable to high-level a reference materials are critical factors in ensuring accuracy of GFR estimates1. Serum cystatin C (Scys) is being proposed as a filtration marker that can be used with or as an alternative to serum creatinine (Scr) in equations to estimate GFR. The Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) published equations for estimating GFR from Scys in 2008 using serums assayed by the Cleveland Clinic Research Laboratory (CCRL) in 2003 using the Siemens-Dade-Behring (SDB) particle-enhanced immunonephelometric assay (PENIA) with the SDB BN II nephelometer2. At that time, Scys assays traceable to an internationally accepted reference material were not available. To foster consistent Scys results, the International Federation for Clinical Chemists (IFCC) Working Group for the Standardization of serum cystatin C and the Institute for Reference Materials and Measurements (IRMM) have collaborated for the production and characterization of a certified reference material (CRM)3, 4. This material, ERM-DA471/IFCC, was made available to laboratories by IRMM in fall 2010. Here we report on the re-expression of previously reported equations to estimate GFR from Scys for use with Scys values traceable to the new IRMM CRM The CKD-EPI Central Laboratory moved to the University of Minnesota (UMN) in 2009. At the time, comparisons between Scys measurement results at CCRL and UMN were made using serum calibration panels, which had been created in 2003 at CCRL and stored frozen at −70°5. The calibration panel included 40 reference sera pooled from at least 10 mixed-sex donors known to have serum creatinine values covering the range of 0.5 to 5.0 mg/dL. The panel was assayed for Scys in triplicate at CCRL in 2003 using the SDB measurement procedure as described above, and at the UMN in 2009 on a panel with one previous freeze thaw cycle using the same SDB PENIA reagent on a SDB ProSpec nephelometer. Conversion factors between the laboratories were determined using Deming linear regression6,7. To ensure stability over time, the calibration panel was retested on a previously unthawed panel at UMN in January 2011. ERM-DA471/IFCC CRM was reconstituted at UMN as instructed in its Certificate of Analysis yielding an aqueous buffer solution with a cystatin C concentration 5.48 mg/L (uncertainty 0.15 mg/L)3. Lower concentration solutions of the reference material were prepared by dilution of the neat reconstituted reference material with volumetric additions of PENIA reagent buffer to create target values of 1.37 mg/L, 2.74 mg/L, and 4.11 mg/L. The instrument PENIA reagent buffer was considered to have zero concentration. Accuracy of volumetric additions was checked by weight. The materials were assayed in duplicate on two separate days. Regression equations were used to compare the mean concentrations assigned by the SDB PENIA reagents on the ProSpec at UMN compared to the calculated values based on the certified value of the reference material. Intercepts that were very small and non-significant (p >0.05) were dropped from the regression. The calibration factor converts Scys results from UMN in 2009 (Scys-UMN’09) reported values to ERM-DA471/IFCC traceable values, which was then incorporated into the GFR estimating equation. Mean (SD, range) level of Scys measured in the calibration panel was 2.01 (0.74, 0.78-3.64) mg/L in CCRL in 2003, 1.67 (0.58, 0.68-2.97) mg/L in UMN in 2009, and 1.67 (0.59, 0.65-2.98) mg/L in UMN 2011. The mean (SD) difference between Scys values from CCRL in 2003 (Scys-CCRL’03) and Scys-UMN’09 was -0.34 (0.16) mg/L (p-value