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Mild impairment of renal function (shrunken pore syndrome) is associated with increased risk for future surgery for aortic stenosis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.ORCID iD: 0000-0002-3002-4877
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
Umeå University, Faculty of Medicine, Department of Biobank Research.ORCID iD: 0000-0003-1227-6859
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
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2019 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 79, no 7, p. 524-530Article in journal (Refereed) Published
Abstract [en]

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. eGFR(cystatin C) and eGFR(creatinine) 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 eGFR(cystatin C) and eGFR(creatinine). 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 eGFR(cystatin C) and eGFR(creatinine) 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.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 79, no 7, p. 524-530
Keywords [en]
Aortic stenosis, valvular replacement, renal insufficiency, creatinine, cystatin C
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-164404DOI: 10.1080/00365513.2019.1664761ISI: 000486559100001PubMedID: 31522562OAI: oai:DiVA.org:umu-164404DiVA, id: diva2:1367767
Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2019-11-05Bibliographically approved

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Ljungberg, JohanJohansson, BengtBergdahl, IngvarHolmgren, AndersNäslund, UlfHultdin, JohanSöderberg, Stefan

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Ljungberg, JohanJohansson, BengtBergdahl, IngvarHolmgren, AndersNäslund, UlfHultdin, JohanSöderberg, Stefan
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CardiologyDepartment of Biobank ResearchClinical chemistry
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Scandinavian Journal of Clinical and Laboratory Investigation
Cardiac and Cardiovascular Systems

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