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Reduced renal elimination of larger molecules is a strong predictor for mortality

Herou, Erik LU orcid ; Grubb, Anders LU orcid ; Dardashti, Alain LU ; Nozohoor, Shahab LU ; Zindovic, Igor LU ; Ederoth, Per LU and Bjursten, Henrik LU (2022) In Scientific Reports 12(1).
Abstract

Renal dysfunction is a major risk factor for premature death and has been studied extensively. A new renal syndrome, shrunken pore syndrome (SPS), confers higher mortality in all studied populations. SPS is a condition in which cystatin C-based estimation of glomerular filtration rate (eGFRcystatin C) is ≥ 60% than creatinine-based estimation of glomerular filtration rate (eGFRcreatinine). We aimed to study the impact of SPS on mortality in a cohort of patients with follow up of up to 10 years. This was a retrospective single centre cohort study. We enrolled 3993 consecutive patients undergoing elective cardiac surgery. Outcome was evaluated using Kaplan Meier analysis and multivariable Cox regression. 1-, 5- and... (More)

Renal dysfunction is a major risk factor for premature death and has been studied extensively. A new renal syndrome, shrunken pore syndrome (SPS), confers higher mortality in all studied populations. SPS is a condition in which cystatin C-based estimation of glomerular filtration rate (eGFRcystatin C) is ≥ 60% than creatinine-based estimation of glomerular filtration rate (eGFRcreatinine). We aimed to study the impact of SPS on mortality in a cohort of patients with follow up of up to 10 years. This was a retrospective single centre cohort study. We enrolled 3993 consecutive patients undergoing elective cardiac surgery. Outcome was evaluated using Kaplan Meier analysis and multivariable Cox regression. 1-, 5- and 10-year survival for patients with SPS was 90%, 59% and 45%, and without SPS 98%, 88% and 80% (p < 0.001). SPS was found to be an independent predictor for mortality with an HR of 1.96 (95% CI 1.63–2.36). SPS negatively affected survival regardless of pre-operative renal function. SPS is an independent predictor for mortality after elective cardiac surgery, equal to or greater than risk factors such as diabetes, impaired left ventricular function or renal dysfunction. SPS affected mortality even in patients with normal eGFR. Clinical registration number: ClinicalTrials.gov, ID NCT04141072.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
12
issue
1
article number
17517
publisher
Nature Publishing Group
external identifiers
  • scopus:85140232880
  • pmid:36266435
ISSN
2045-2322
DOI
10.1038/s41598-022-22433-4
language
English
LU publication?
no
additional info
Funding Information: The investigation was supported by grants from Skåne University Hospital Funds, the Medical Faculty of Lund University, and the Swedish Heart-Lung foundation. Publisher Copyright: © 2022, The Author(s).
id
6515302e-26af-4b33-be1a-f47488754052
date added to LUP
2022-10-31 10:49:46
date last changed
2024-06-12 23:09:03
@article{6515302e-26af-4b33-be1a-f47488754052,
  abstract     = {{<p>Renal dysfunction is a major risk factor for premature death and has been studied extensively. A new renal syndrome, shrunken pore syndrome (SPS), confers higher mortality in all studied populations. SPS is a condition in which cystatin C-based estimation of glomerular filtration rate (eGFR<sub>cystatin C</sub>) is ≥ 60% than creatinine-based estimation of glomerular filtration rate (eGFR<sub>creatinine</sub>). We aimed to study the impact of SPS on mortality in a cohort of patients with follow up of up to 10 years. This was a retrospective single centre cohort study. We enrolled 3993 consecutive patients undergoing elective cardiac surgery. Outcome was evaluated using Kaplan Meier analysis and multivariable Cox regression. 1-, 5- and 10-year survival for patients with SPS was 90%, 59% and 45%, and without SPS 98%, 88% and 80% (p &lt; 0.001). SPS was found to be an independent predictor for mortality with an HR of 1.96 (95% CI 1.63–2.36). SPS negatively affected survival regardless of pre-operative renal function. SPS is an independent predictor for mortality after elective cardiac surgery, equal to or greater than risk factors such as diabetes, impaired left ventricular function or renal dysfunction. SPS affected mortality even in patients with normal eGFR. Clinical registration number: ClinicalTrials.gov, ID NCT04141072.</p>}},
  author       = {{Herou, Erik and Grubb, Anders and Dardashti, Alain and Nozohoor, Shahab and Zindovic, Igor and Ederoth, Per and Bjursten, Henrik}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Reduced renal elimination of larger molecules is a strong predictor for mortality}},
  url          = {{http://dx.doi.org/10.1038/s41598-022-22433-4}},
  doi          = {{10.1038/s41598-022-22433-4}},
  volume       = {{12}},
  year         = {{2022}},
}