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Association of Osteopontin and selective glomerular hypofiltration syndrome with hospitalization for kidney failure in acute heart failure patients

Ohlsson, Marcus Andreas LU orcid ; Nilsson, Christopher LU orcid ; Molvin, John LU ; Isholth, Hannes Holm LU ; Grubb, Anders LU orcid ; Christensson, Anders LU ; Jujic, Amra LU orcid and Magnusson, Martin LU orcid (2025) In BMC Nephrology 26. p.1-10
Abstract

BACKGROUND: Selective glomerular hypofiltration syndrome (SGHS), formerly shrunken pore syndrome, an emerging marker of glomerular dysfunction, is associated with worsened prognosis in cardiovascular disease, but its role in kidney failure remains underexplored. Osteopontin (OPN) is associated with worsening kidney function and prognosis in chronic kidney disease.

PURPOSE: To explore if increased levels of OPN and SGHS are associated with hospitalization for kidney failure in patients with acute heart failure (HF).

METHODS: OPN was analyzed in 315 hospitalized HF patients using a proximity extension assay. SGHS was defined as cystatin C-based estimated GFR (eGFR) < 60% of the creatinine-based eGFR. Clinical outcomes were... (More)

BACKGROUND: Selective glomerular hypofiltration syndrome (SGHS), formerly shrunken pore syndrome, an emerging marker of glomerular dysfunction, is associated with worsened prognosis in cardiovascular disease, but its role in kidney failure remains underexplored. Osteopontin (OPN) is associated with worsening kidney function and prognosis in chronic kidney disease.

PURPOSE: To explore if increased levels of OPN and SGHS are associated with hospitalization for kidney failure in patients with acute heart failure (HF).

METHODS: OPN was analyzed in 315 hospitalized HF patients using a proximity extension assay. SGHS was defined as cystatin C-based estimated GFR (eGFR) < 60% of the creatinine-based eGFR. Clinical outcomes were retrieved from regional registries (ICD-10 N17-N19). Multivariable logistic and Cox regression models adjusted for known risk factors were used for associations between OPN and SGHS and their association with hospitalization for kidney failure.

RESULTS: The mean age was 74 years, 33% were female and 15% presented with SGHS. Patients with SGHS had higher BMI, OPN- and cystatin C levels and higher mean eGFR. During the median follow-up period of 28 months, 46 patients were hospitalized for kidney failure. Increased OPN-levels were associated with prevalent SGHS (odds ratio 2.50, p < 0.001), and higher risk of hospitalization for acute kidney failure (hazard ratio (HR) 4.66, p < 0.001) as did prevalent SGHS (HR 4.82, p < 0.001).

CONCLUSIONS: In HF patients, OPN was associated with a higher prevalence of SGHS and both OPN and SGHS were associated with higher risk of hospitalization for kidney failure. Our results suggest that OPN and SGHS can identify HF patients at high risk of kidney function decline.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Female, Male, Osteopontin/blood, Aged, Heart Failure/blood, Hospitalization/trends, Glomerular Filtration Rate/physiology, Renal Insufficiency/blood, Middle Aged, Aged, 80 and over, Acute Disease, Biomarkers/blood, Syndrome, Cystatin C/blood
in
BMC Nephrology
volume
26
article number
550
pages
1 - 10
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41053620
  • scopus:105017931726
ISSN
1471-2369
DOI
10.1186/s12882-025-04481-w
language
English
LU publication?
yes
additional info
© 2025. The Author(s).
id
c8632cde-16a9-4e98-9043-bd0ee1d54429
date added to LUP
2025-10-07 18:54:57
date last changed
2025-12-23 05:59:43
@article{c8632cde-16a9-4e98-9043-bd0ee1d54429,
  abstract     = {{<p>BACKGROUND: Selective glomerular hypofiltration syndrome (SGHS), formerly shrunken pore syndrome, an emerging marker of glomerular dysfunction, is associated with worsened prognosis in cardiovascular disease, but its role in kidney failure remains underexplored. Osteopontin (OPN) is associated with worsening kidney function and prognosis in chronic kidney disease.</p><p>PURPOSE: To explore if increased levels of OPN and SGHS are associated with hospitalization for kidney failure in patients with acute heart failure (HF).</p><p>METHODS: OPN was analyzed in 315 hospitalized HF patients using a proximity extension assay. SGHS was defined as cystatin C-based estimated GFR (eGFR) &lt; 60% of the creatinine-based eGFR. Clinical outcomes were retrieved from regional registries (ICD-10 N17-N19). Multivariable logistic and Cox regression models adjusted for known risk factors were used for associations between OPN and SGHS and their association with hospitalization for kidney failure.</p><p>RESULTS: The mean age was 74 years, 33% were female and 15% presented with SGHS. Patients with SGHS had higher BMI, OPN- and cystatin C levels and higher mean eGFR. During the median follow-up period of 28 months, 46 patients were hospitalized for kidney failure. Increased OPN-levels were associated with prevalent SGHS (odds ratio 2.50, p &lt; 0.001), and higher risk of hospitalization for acute kidney failure (hazard ratio (HR) 4.66, p &lt; 0.001) as did prevalent SGHS (HR 4.82, p &lt; 0.001).</p><p>CONCLUSIONS: In HF patients, OPN was associated with a higher prevalence of SGHS and both OPN and SGHS were associated with higher risk of hospitalization for kidney failure. Our results suggest that OPN and SGHS can identify HF patients at high risk of kidney function decline.</p>}},
  author       = {{Ohlsson, Marcus Andreas and Nilsson, Christopher and Molvin, John and Isholth, Hannes Holm and Grubb, Anders and Christensson, Anders and Jujic, Amra and Magnusson, Martin}},
  issn         = {{1471-2369}},
  keywords     = {{Humans; Female; Male; Osteopontin/blood; Aged; Heart Failure/blood; Hospitalization/trends; Glomerular Filtration Rate/physiology; Renal Insufficiency/blood; Middle Aged; Aged, 80 and over; Acute Disease; Biomarkers/blood; Syndrome; Cystatin C/blood}},
  language     = {{eng}},
  month        = {{10}},
  pages        = {{1--10}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Nephrology}},
  title        = {{Association of Osteopontin and selective glomerular hypofiltration syndrome with hospitalization for kidney failure in acute heart failure patients}},
  url          = {{http://dx.doi.org/10.1186/s12882-025-04481-w}},
  doi          = {{10.1186/s12882-025-04481-w}},
  volume       = {{26}},
  year         = {{2025}},
}