Mild impairment of renal function (shrunken pore syndrome) is associated with increased risk for future surgery for aortic stenosis.
Johan LjungbergBengt JohanssonIngvar A BergdahlAnders HolmgrenUlf NäslundJohan HultdinStefan SöderbergPublished in: Scandinavian journal of clinical and laboratory investigation (2019)
Recently, a new approach was proposed to detect mild impairment in renal function: a reduced ratio between estimated glomerular filtration rate (eGFR) calculated by cystatin C and eGFR calculated by creatinine. We aimed to evaluate if this ratio is associated with aortic stenosis (AS) requiring surgery. We identified 336 patients that first participated in population surveys and later underwent surgery for AS (median age [interquartile range] 59.8 [10.3] years at survey and 68.3 [12.7] at surgery, 48% females). For each patient, two matched referents were allocated. Cystatin C and creatinine were determined in stored plasma. eGFRcystatin C and eGFRcreatinine and their ratio were estimated. Conditional logistic regression analyses were used to estimate the risk (odds ratio (OR) with [95% confidence interval (CI)]) related to one (ln) standard deviation increase in the ratio between eGFRcystatin C and eGFRcreatinine. A high ratio was associated with lower risk for AS requiring surgery (OR [95% CI]) (OR 0.84 [0.73-0.97]), especially in women (0.74 [0.60-0.92] vs. 0.93 [0.76-1.13] in men). After further stratification for coronary artery disease (CAD), the association remained in women with CAD but not in women without CAD (0.60 [0.44-0.83] and 0.89 [0.65-1.23], respectively). In conclusion, a high ratio between eGFRcystatin C and eGFRcreatinine was associated with lower risk for surgery for AS, especially in women. Mild impairment of renal function is thus associated with future risk for AS requiring surgery.
Keyphrases
- minimally invasive
- coronary artery bypass
- coronary artery disease
- aortic stenosis
- ejection fraction
- surgical site infection
- small cell lung cancer
- percutaneous coronary intervention
- left ventricular
- aortic valve replacement
- aortic valve
- polycystic ovary syndrome
- transcatheter aortic valve implantation
- pregnant women
- end stage renal disease
- chronic kidney disease
- newly diagnosed
- cardiovascular events
- cardiovascular disease
- type diabetes
- epidermal growth factor receptor
- adipose tissue
- breast cancer risk
- acute coronary syndrome
- prognostic factors
- drug induced
- middle aged