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Shrunken pore syndrome and mortality : a cohort study of patients with measured GFR and known comorbidities

Åkesson, Anna LU orcid ; Lindström, Veronica LU orcid ; Nyman, Ulf LU ; Jonsson, Magnus LU orcid ; Abrahamson, Magnus LU ; Christensson, Anders LU ; Björk, Jonas LU and Grubb, Anders LU orcid (2020) In Scandinavian Journal of Clinical and Laboratory Investigation 80(5). p.412-422
Abstract

Shrunken pore syndrome (SPS) is defined by a cystatin C-based estimation of glomerular filtration rate (eGFRCYS) being less than 60% or 70% of a creatinine-based GFR estimation (eGFRCR) in the absence of extrarenal influences on cystatin C or creatinine concentrations. SPS has been associated with a substantial increase in mortality or morbidity in all investigated populations. However, in these studies, neither the diagnoses, nor causes of death were described, and only estimated GFR was available. The present study concerns 2781 individuals with measured GFR (mGFR), known diagnoses, and known causes of death during 5.6 years in median. Cox multivariate proportional hazards regression model was used to estimate hazard ratios (HR) for... (More)

Shrunken pore syndrome (SPS) is defined by a cystatin C-based estimation of glomerular filtration rate (eGFRCYS) being less than 60% or 70% of a creatinine-based GFR estimation (eGFRCR) in the absence of extrarenal influences on cystatin C or creatinine concentrations. SPS has been associated with a substantial increase in mortality or morbidity in all investigated populations. However, in these studies, neither the diagnoses, nor causes of death were described, and only estimated GFR was available. The present study concerns 2781 individuals with measured GFR (mGFR), known diagnoses, and known causes of death during 5.6 years in median. Cox multivariate proportional hazards regression model was used to estimate hazard ratios (HR) for all-cause and cancer, cardiovascular, diabetes or chronic kidney disease (CKD) as cause-specific mortality among patients with SPS. At an eGFRCYS/eGFRCR-ratio <0.70, the adjusted SPS death risk in the total cohort (HR 3.0, 95% CI 2.4-3.7) was clearly higher than that for the other diagnosis groups. In a sub-cohort of 1300 persons with or without diagnosis, but with normal mGFR, the all-cause mortality of SPS was markedly increased (HR 4.1, 95% CI 2.6-6.5). In a sub-cohort of 567 persons with normal mGFR and no diagnosis, the all-cause mortality of SPS was even more increased (HR 7.3, 95% CI 2.3-23). The prevalence of SPS in the total cohort was 23% and in the sub-cohorts 17 and 12%, respectively. As SPS is associated with a high mortality, occurs in the absence of reduced mGFR and albuminuria, it expands the spectrum of kidney disorders.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Clinical and Laboratory Investigation
volume
80
issue
5
pages
11 pages
publisher
Informa Healthcare
external identifiers
  • pmid:32459111
  • scopus:85086327535
ISSN
1502-7686
DOI
10.1080/00365513.2020.1759139
project
AIR Lund - Artificially Intelligent use of Registers
Shrunken Pore Syndrome (SPS) - morbidity and mortality in a population with measured glomerular filtration rate (GFR)
language
English
LU publication?
yes
id
b9f46580-e569-4f15-9d6e-3d714f1e743f
date added to LUP
2020-06-09 12:59:01
date last changed
2024-04-17 10:09:29
@article{b9f46580-e569-4f15-9d6e-3d714f1e743f,
  abstract     = {{<p>Shrunken pore syndrome (SPS) is defined by a cystatin C-based estimation of glomerular filtration rate (eGFRCYS) being less than 60% or 70% of a creatinine-based GFR estimation (eGFRCR) in the absence of extrarenal influences on cystatin C or creatinine concentrations. SPS has been associated with a substantial increase in mortality or morbidity in all investigated populations. However, in these studies, neither the diagnoses, nor causes of death were described, and only estimated GFR was available. The present study concerns 2781 individuals with measured GFR (mGFR), known diagnoses, and known causes of death during 5.6 years in median. Cox multivariate proportional hazards regression model was used to estimate hazard ratios (HR) for all-cause and cancer, cardiovascular, diabetes or chronic kidney disease (CKD) as cause-specific mortality among patients with SPS. At an eGFRCYS/eGFRCR-ratio &lt;0.70, the adjusted SPS death risk in the total cohort (HR 3.0, 95% CI 2.4-3.7) was clearly higher than that for the other diagnosis groups. In a sub-cohort of 1300 persons with or without diagnosis, but with normal mGFR, the all-cause mortality of SPS was markedly increased (HR 4.1, 95% CI 2.6-6.5). In a sub-cohort of 567 persons with normal mGFR and no diagnosis, the all-cause mortality of SPS was even more increased (HR 7.3, 95% CI 2.3-23). The prevalence of SPS in the total cohort was 23% and in the sub-cohorts 17 and 12%, respectively. As SPS is associated with a high mortality, occurs in the absence of reduced mGFR and albuminuria, it expands the spectrum of kidney disorders.</p>}},
  author       = {{Åkesson, Anna and Lindström, Veronica and Nyman, Ulf and Jonsson, Magnus and Abrahamson, Magnus and Christensson, Anders and Björk, Jonas and Grubb, Anders}},
  issn         = {{1502-7686}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{5}},
  pages        = {{412--422}},
  publisher    = {{Informa Healthcare}},
  series       = {{Scandinavian Journal of Clinical and Laboratory Investigation}},
  title        = {{Shrunken pore syndrome and mortality : a cohort study of patients with measured GFR and known comorbidities}},
  url          = {{http://dx.doi.org/10.1080/00365513.2020.1759139}},
  doi          = {{10.1080/00365513.2020.1759139}},
  volume       = {{80}},
  year         = {{2020}},
}