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Selective Glomerular Hypofiltration Syndrome / Syndrome / Acute Kidney Injury · Journal article
Annals of Medicine · August 26, 2026
Encouraging direction, but not yet definitive.
In a retrospective cohort of 1277 patients undergoing isolated coronary artery bypass grafting, shrunken pore syndrome (defined as eGFR cystatin C ≤70% of eGFR creatinine) was independently associated with increased risk of acute kidney injury within seven days postoperatively. The adjusted odds ratio was 1.613 (95% CI 1.121–2.322, p = 0.010) and remained significant after propensity score matching (adjOR = 1.702, 95% CI 1.131–2.560, p = 0.011), with an E-value of 2.175 indicating modest residual confounding cannot be excluded.
Single-centre, retrospective cohort study. Patients undergoing isolated coronary artery bypass grafting at the Affiliated Hospital of Qingdao University between 1 January 2017 and 1 January 2021.. Intervention: Preoperative shrunken pore syndrome (eGFR cystatin C ≤70% of eGFR creatinine) exposure status.. Compared with: Absence of shrunken pore syndrome (eGFR cystatin C >70% of eGFR creatinine).. n = 1,277. Single centre: the Affiliated Hospital of Qingdao University, Qingdao, China..
Overall postoperative AKI incidence was 23.2% (296/1277) SPS prevalence was 12.8% (164/1277) before surgery AKI incidence in SPS group 33.5% vs non-SPS group 21.7%, adjOR = 1.613, 95% CI 1.121–2.322, p = 0.010
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These findings suggest that preoperative identification of shrunken pore syndrome may refine risk stratification for postoperative acute kidney injury in cardiac surgery patients and could inform targeted prevention strategies. However, single-centre retrospective design and modest effect size warrant prospective validation before implementation into clinical practice.
Retrospective cohort study in a single centre showing a statistically significant association between shrunken pore syndrome and postoperative acute kidney injury after cardiac surgery, with adequate sample size and sensitivity analysis, but limited by observational design and lack of prospective validation.
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These findings suggest that preoperative identification of shrunken pore syndrome may refine risk stratification for postoperative acute kidney injury in cardiac surgery patients and could inform targeted prevention strategies. However, single-centre retrospective design and modest effect size warrant prospective validation before implementation into clinical practice.
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Background. Shrunken pore syndrome (SPS), as a selective glomerular hypofiltration syndrome, has received increasing attention. Therefore, we hypothesised that patients with SPS have a high risk of postoperative acute kidney injury (AKI).Methods. This trial was a retrospective cohort study. Patients who received isolated coronary artery bypass grafting (CABG) in the Affiliated Hospital of Qingdao University were continuously reviewed. Estimated glomerular filtration rates (eGFRs) were calculated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. The SPS was defined as an eGFR based on cystatin C < 70% of the eGFR based on creatinine. Postoperative AKI was diagnosed according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, and the occurrence of AKI within seven days after surgery was followed up.Results. A total of 1277 patients were included, and the incidence of postoperative AKI was 23.2% (296/1277), and 12.8% (164/1277) patients were diagnosed with SPS before surgery. The incidence of AKI in the SPS group was significantly higher than that in the non-SPS group (33.5% vs. 21.7%, adjOR = 1.613, 95%CI 1.121-2.322, p = 0.010). Sensitivity analysis: E-value = 2.175 and Fragility Index = 8. The results remained robust across all subgroups. After propensity score matching, the incidence of AKI in SPS group was still significantly higher than that in the non-SPS group (33.5% vs. 22.9%, adjOR = 1.702, 95%CI 1.131-2.560, p = 0.011).Conclusions. SPS is an independent risk factor for AKI after CABG. It will bring a new insight for an accurate clinical assessment of the risk of postoperative AKI.
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