The mortality increase in cardiac surgery patients associated with shrunken pore syndrome correlates with the eGFRcystatin C/eGFRcreatinine-ratio

Autor:	Per Ederoth, Igor Zindovic, Shahab Nozohoor, Alain Dardashti, Anders Grubb, Erik Herou, Henrik Bjursten
Rok vydání:	2019
Předmět:	0301 basic medicine medicine.medical_specialty Bypass grafting Clinical Biochemistry Population Urology Renal function 030204 cardiovascular system & hematology urologic and male genital diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Aortic valve replacement medicine education education.field_of_study Creatinine biology business.industry General Medicine medicine.disease female genital diseases and pregnancy complications Cardiac surgery 030104 developmental biology medicine.anatomical_structure Cystatin C chemistry biology.protein business Artery
Zdroj:	Scandinavian Journal of Clinical and Laboratory Investigation. 79:167-173
ISSN:	1502-7686 0036-5513
Popis:	Shrunken pore syndrome (SPS) is a condition in which estimated glomerular filtration rate (eGFR) based upon cystatin C is lower than eGFR based upon creatinine. It has been associated with increased mortality even in the presence of normal GFR in both a cardiac surgical population and a general population. No systematic studies of the variation in eGFR cystatin C /eGFR creatinine -ratio used for SPS diagnosis have been published. This study aims to evaluate whether early and midterm mortality following elective cardiac surgery varies with the ratio used to identify SPS. Preoperative levels of cystatin C and creatinine were analysed in 4007 patients undergoing elective coronary artery bypass grafting (CABG) and/or surgical aortic valve replacement (sAVR). The eGFR cystatin C /eGFR creatinine -ratio was calculated based on the equation pairs CKD-EPI cystatin C /CKD-EPI creatinine and CAPA/LMrev. The overall 1- and 3-year all-cause mortality was 2.9 and 6.8%, respectively. Mean follow-up time was 3.6 years. Mortality markedly and progressively increased with a decrease in the eGFR cystatin C /eGFR creatinine -ratio for both equation pairs. An increase in mortality was noted already when the ratio decreased from 1.0 to 0.90. To facilitate the clinical decisions based upon the SPS-defining eGFR cystatin C /eGFR creatinine -ratio, we calculated both the ratios defining the highest combined sensitivity and specificity and the ratios producing a high specificity of 95%, finding different cut-off for these scenarios.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::aec4576e646461ea0a2ed29330a07328 https://doi.org/10.1080/00365513.2019.1576101 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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