Identification of cystatin C as a new marker of glomerular filtration rate, and of shrunken pore syndrome – a new kidney disorder defining selective glomerular hypofiltration syndromes – calls for expansion of the international KDIGO guidelines
(2025) In Scandinavian Journal of Clinical and Laboratory Investigation- Abstract
- Cystatin C was identified as a marker of glomerular filtration rate (GFR) in 1979, and the parallel analysis of cystatin C and creatinine led to the identification of shrunken pore syndrome (SPS) ? a new kidney disorder ? in 2015. Since then, it has been shown that cystatin C in many aspects is superior to creatinine as a marker of GFR and cardiovascular risk. SPS, an entity within the selective glomerular hypofiltration syndromes (SGHS), has been demonstrated to be associated with a strong increase in morbidity and mortality in several populations. Despite the seriousness of SPS and SGHS, and the availability of potential treatments, many patients with these conditions remain undiagnosed, due to the limitations of the international Kidney... (More)
- Cystatin C was identified as a marker of glomerular filtration rate (GFR) in 1979, and the parallel analysis of cystatin C and creatinine led to the identification of shrunken pore syndrome (SPS) ? a new kidney disorder ? in 2015. Since then, it has been shown that cystatin C in many aspects is superior to creatinine as a marker of GFR and cardiovascular risk. SPS, an entity within the selective glomerular hypofiltration syndromes (SGHS), has been demonstrated to be associated with a strong increase in morbidity and mortality in several populations. Despite the seriousness of SPS and SGHS, and the availability of potential treatments, many patients with these conditions remain undiagnosed, due to the limitations of the international Kidney Disease Improving Global Outcomes Organization (KDIGO) guidelines. Given the significant clinical advantages of cystatin C in diagnosing and treating kidney disorders, there is a need to expand the KDIGO guidelines to include cystatin C measurements alongside creatinine at least in the initial patient evaluation but also in follow-up evaluations. This would improve the early detection and management of patients with kidney diseases, ultimately enhancing patient outcomes. The present discourse summarizes the development of this understanding from the original observations in 1979 and 2015 to the latest findings. (Less)
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https://lup.lub.lu.se/record/f1c62ff6-20b4-42c9-a9f9-4fc40e9e2e0c
- author
- organization
-
- Epidemiology and population studies (EPI@Lund) (research group)
- Centre for Economic Demography
- Division of Occupational and Environmental Medicine, Lund University
- Renal physiology and peritoneal dialysis (research group)
- Nephrology
- LU Profile Area: Proactive Ageing
- Geriatrics (research group)
- Orthopedics (research group)
- Internal Medicine - Epidemiology (research group)
- Division of Clinical Chemistry and Pharmacology
- Cystatin C, renal disease, amyloidosis and antibiotics (research group)
- Protease Inhibitor Research (research group)
- LUCC: Lund University Cancer Centre
- EpiHealth: Epidemiology for Health
- Teachers at the Medical Programme
- Less invasive cardiac surgery (research group)
- Thoracic Surgery
- Pediatric anesthesia and intensive care (research group)
- Anesthesiology and Intensive Care
- Minimal invasive cardiac surgery in valvular heart disease (research group)
- Bleeding disorders and acute typ-A dissection (research group)
- Heparin bindning protein in cardiothoracic surgery (research group)
- Obstetrics and Gynaecology (Lund)
- WCMM-Wallenberg Centre for Molecular Medicine
- Cardiovascular Research - Hypertension (research group)
- Radiology Diagnostics, Malmö (research group)
- Infect@LU
- LU Profile Area: Nature-based future solutions
- Surgery and public health (research group)
- eSSENCE: The e-Science Collaboration
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Scandinavian Journal of Clinical and Laboratory Investigation
- pages
- 11 pages
- publisher
- Informa Healthcare
- external identifiers
-
- pmid:40888652
- ISSN
- 0036-5513
- DOI
- 10.1080/00365513.2025.2546320
- language
- English
- LU publication?
- yes
- id
- f1c62ff6-20b4-42c9-a9f9-4fc40e9e2e0c
- date added to LUP
- 2025-09-02 16:32:48
- date last changed
- 2025-09-12 13:27:49
@article{f1c62ff6-20b4-42c9-a9f9-4fc40e9e2e0c, abstract = {{Cystatin C was identified as a marker of glomerular filtration rate (GFR) in 1979, and the parallel analysis of cystatin C and creatinine led to the identification of shrunken pore syndrome (SPS) ? a new kidney disorder ? in 2015. Since then, it has been shown that cystatin C in many aspects is superior to creatinine as a marker of GFR and cardiovascular risk. SPS, an entity within the selective glomerular hypofiltration syndromes (SGHS), has been demonstrated to be associated with a strong increase in morbidity and mortality in several populations. Despite the seriousness of SPS and SGHS, and the availability of potential treatments, many patients with these conditions remain undiagnosed, due to the limitations of the international Kidney Disease Improving Global Outcomes Organization (KDIGO) guidelines. Given the significant clinical advantages of cystatin C in diagnosing and treating kidney disorders, there is a need to expand the KDIGO guidelines to include cystatin C measurements alongside creatinine at least in the initial patient evaluation but also in follow-up evaluations. This would improve the early detection and management of patients with kidney diseases, ultimately enhancing patient outcomes. The present discourse summarizes the development of this understanding from the original observations in 1979 and 2015 to the latest findings.}}, author = {{Åkesson, Anna and Öberg, Carl and Malmgren, Linnea and Nilsson, Christopher and Itoh, Yoshi and Blirup-Jensen, Søren and Lindström, Veronica and Abrahamson, Magnus and Leion, Felicia and Olafsson, Isleifur and Bjursten, Henrik and Grubb, David and Herou, Erik and Dardashti, Alain and Sigurjonsson, Johann and Xhakollari, Liana and Laucyte-Cibulskiene, Agne and Pottel, Hans and Strevens, Helena and Damm, Danielle and Förnvik Jonsson, Magnus and Siódmiak, Joanna and Ärnlöv, Johan and Larsson, Anders and Åkerfeldt, Torbjörn and Kultima, Kim and Ridefelt, Peter and Helmersson-Karlqvist, Johanna and Magnusson, Martin and Hansson, Magnus and Sjöström, Anna and Soveri, Inga and Tenstad, Olav and Mårtensson, Johan and Elinder, Carl-Gustaf and Risch, Lorenz and Risch, Martin and Hansson, Lars-Olof and Price, Christopher P. and Nyman, Ulf and Björk, Jonas and Delanaye, Pierre and Bökenkamp, Arend and Christensson, Anders and Grubb, Anders}}, issn = {{0036-5513}}, language = {{eng}}, publisher = {{Informa Healthcare}}, series = {{Scandinavian Journal of Clinical and Laboratory Investigation}}, title = {{Identification of cystatin C as a new marker of glomerular filtration rate, and of shrunken pore syndrome – a new kidney disorder defining selective glomerular hypofiltration syndromes – calls for expansion of the international KDIGO guidelines}}, url = {{http://dx.doi.org/10.1080/00365513.2025.2546320}}, doi = {{10.1080/00365513.2025.2546320}}, year = {{2025}}, }