ASSOCIATION OF SERUM ALBUMIN AND HOMOCYSTEINE WITH SHRUNKEN PORE SYNDROME (SPS)
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Abstract
Objective: Creatinine-based estimated glomerular filtration rate (eGFR) may be influenced by non-renal factors, whereas cystatin C provides a less confounded marker. Shrunken Pore Syndrome (SPS) is characterized by reduced filtration of medium-sized molecules and has been strongly associated with cardiovascular mortality. This study aimed to identify biochemical factors associated with discrepancies between creatinine- and cystatin C–based eGFR in SPS among Vietnamese CKD patients.
Methods: A cross-sectional study was conducted in 233 patients with chronic kidney disease at the Outpatient Department of the University Medical Center Ho Chi Minh City, Campus 2. Four regression models were used to analyze filtration difference (diffcreacys = eGFRcrea − eGFRcysC), significant discrepancy (|diffcreacys| ≥ 15), filtration ratio (eGFRcysC/eGFRcrea), and SPS status (defined as eGFRcysC/eGFRcrea < 0.7). Independent variables included sex, age, serum albumin, homocysteine, LDL-C, HbA1c, and BMI.
Results: Female sex was associated with a lower eGFRcysC/eGFRcrea ratio (β = −0.103, p < 0.001). Older age increased the likelihood of pore shrinkage (β = −0.0026, p < 0.05). Higher serum albumin was associated with an increased eGFRcysC/eGFRcrea ratio (β = 0.138, p < 0.001) and reduced diffcreacys (β = 5.51, p = 0.001). Homocysteine was associated with diffcreacys (OR = 0.92, p < 0.05), while LDL-C showed a weak association with the filtration ratio (β = 0.0006, p < 0.05).
Conclusion: Discrepancies between creatinine- and cystatin C–based eGFR may reflect glomerular filtration barrier pathology rather than simple estimation error. SPS appears more prevalent among women and older individuals. Serum albumin and homocysteine may serve as potential markers of SPS, which may contribute to increased cardiovascular risk through the accumulation of atherogenic proteins.
Keywords
Shrunken Pore Syndrome, creatinine, cystatin C, eGFR discrepancy.
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References
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