Krympt por-syndrom – ett nyupptäckt syndrom med hög prevalens och mortalitet

Shrunken Pore Syndrome was defined in 2015 and is characterised by the glomerular filtration of 5-40 kDa molecules being selectively decreased compared to that of molecules <0.2 kDa, e.g. water and creatinine. The diagnose is based upon identification of a decreased eGFRcystatin C/eGFRcreatinine ratio, and ratios -< 0.6 or 0.7 have most often been used to identify the diagnose. The mortality is strongly increased in all investigated populations and increases progressively with a decrease in the eGFRcystatin C/eGFRcreatinine ratio used to identify the syndrome. The prevalence of the syndrome varies with the eGFRcystatin C/eGFRcreatinine ratio used for diagnosis, but when a ratio of 0.6 is used, the prevalence has varied between 2 and 8%. The pathophysiology might be the accumulation of atherosclerosis-promoting proteins occurring in patients with the syndrome. The syndrome might explain the superiority of eGFRcystatin C over eGFRcreatinine in identifying high-risk kidney patients.