Identification of cystatin C as a new marker of glomerular filtration rate, and of shrunken pore syndrome - a new kidney disorder defining selective glomerular hypofiltration syndromes - calls for expansion of the international KDIGO guidelines. - 2025
Identification of cystatin C as a new marker of glomerular filtration rate, and of shrunken pore syndrome - a new kidney disorder defining selective glomerular hypofiltration syndromes - calls for expansion of the international KDIGO guidelines.
[en] Cystatin C was identified as a marker of glomerular filtration rate (GFR) in 1979, and the parallel analysis of cystatin C and creatinine led to the identification of shrunken pore syndrome (SPS) - a new kidney disorder - in 2015. Since then, it has been shown that cystatin C in many aspects is superior to creatinine as a marker of GFR and cardiovascular risk. SPS, an entity within the selective glomerular hypofiltration syndromes (SGHS), has been demonstrated to be associated with a strong increase in morbidity and mortality in several populations. Despite the seriousness of SPS and SGHS, and the availability of potential treatments, many patients with these conditions remain undiagnosed, due to the limitations of the international Kidney Disease Improving Global Outcomes Organization (KDIGO) guidelines. Given the significant clinical advantages of cystatin C in diagnosing and treating kidney disorders, there is a need to expand the KDIGO guidelines to include cystatin C measurements alongside creatinine at least in the initial patient evaluation but also in follow-up evaluations. This would improve the early detection and management of patients with kidney diseases, ultimately enhancing patient outcomes. The present discourse summarizes the development of this understanding from the original observations in 1979 and 2015 to the latest findings.
Disciplines :
Urology & nephrology
Author, co-author :
Åkesson, Anna ; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden ; Clinical Studies Sweden - Forum South, Skåne University Hospital, Lund, Sweden
Öberg, Carl ; Department of Clinical Sciences Lund, Lund University, Lund, Sweden ; Department of Nephrology, Skåne University Hospital, Lund, Sweden
Malmgren, Linnea ; Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden ; Department of Geriatrics, Skåne University Hospital, Malmö, Sweden
Nilsson, Christopher ; Department of Clinical Sciences, Malmö, Lund University, Sweden Lund
Itoh, Yoshi; Clinical Laboratory, Eiju General Hospital, Life Extension Research Institute, Tokyo, Japan
Blirup-Jensen, Søren; Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, Lund University, Lund, Sweden
Lindström, Veronica; Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, Lund University, Lund, Sweden
Abrahamson, Magnus ; Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, Lund University, Lund, Sweden
Leion, Felicia; Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, Lund University, Lund, Sweden
Olafsson, Isleifur; Department of Clinical Biochemistry, Landspitali - National University Hospital of Iceland, Reykjavik, Iceland
Bjursten, Henrik ; Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden
Grubb, David; Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden
Herou, Erik ; Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden
Dardashti, Alain ; Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden
Sigurjonsson, Johann; Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden
Xhakollari, Liana; Department of Clinical Sciences, Malmö, Lund University, Sweden Lund ; Department of Nephrology, Skåne University Hospital, Malmö, Sweden
Laucyte-Cibulskiene, Agne ; Department of Clinical Sciences, Malmö, Lund University, Sweden Lund
Pottel, Hans ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Public Health and Primary Care, KULeuven Campus Kulak Kortrijk, Kortrijk, Belgium
Strevens, Helena ; Department of Obstetrics and Gynecology, Lund University, Skåne University Hospital, Lund, Sweden
Damm, Danielle; Department of Obstetrics and Gynecology, Lund University, Skåne University Hospital, Lund, Sweden
Förnvik Jonsson, Magnus ; Department of Clinical Chemistry and Pharmacology, Skåne University Hospital, Lund, Sweden
Siódmiak, Joanna ; Department of Laboratory Medicine, Faculty of Pharmacy, Ludwik Rydygier Collegium Medicum (Nicolaus Copernicus University in Torun), Bydgoszcz, Poland
Ärnlöv, Johan ; Department of Neurobiology, Care Sciences and Society (NVS), Family Medicine and Primary Care Unit, Karolinska Institute, Huddinge, Sweden ; School of Health and Social Studies, Dalarna University, Falun, Sweden
Larsson, Anders ; Department of Medical Sciences, Clinical Chemistry, Uppsala University Hospital, Uppsala, Sweden
Åkerfeldt, Torbjörn; Department of Medical Sciences, Clinical Chemistry, Uppsala University Hospital, Uppsala, Sweden
Kultima, Kim ; Department of Medical Sciences, Clinical Chemistry, Uppsala University Hospital, Uppsala, Sweden
Ridefelt, Peter ; Department of Medical Sciences, Clinical Chemistry, Uppsala University Hospital, Uppsala, Sweden
Helmersson-Karlqvist, Johanna ; Department of Medical Sciences, Clinical Chemistry, Uppsala University Hospital, Uppsala, Sweden
Magnusson, Martin ; Department of Clinical Sciences, Lund University, Malmö, Sweden ; Department of Cardiology, Skåne University Hospital, Malmö, Sweden ; Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden ; Hypertension in Africa Research Team (HART), North West University, Potchefstroom, South Africa
Hansson, Magnus ; Department of Laboratory Medicine, Division of Clinical Chemistry, Karolinska Institutet, Stockholm and Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
Sjöström, Anna ; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm and Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
Soveri, Inga; Department of Medical Sciences, Nephrology Uppsala University Hospital, Uppsala, Sweden
Tenstad, Olav ; Department of Biomedicine, University of Bergen, Bergen, Norway
Mårtensson, Johan ; Department of Physiology and Pharmacology, Section of Anaesthesia and Intensive Care, Karolinska Institute, Stockholm, Sweden
Elinder, Carl-Gustaf; Division of Renal Medicine, Department of Clinical Intervention, and Technology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
Risch, Lorenz ; Faculty of Medical Sciences, Private University in the Principality of Liechtenstein, Triesen, Liechtenstein ; University Institute of Clinical Chemistry, University Hospital and University of Bern, Inselspital, Bern, Switzerland
Risch, Martin ; Central Laboratory, Cantonal Hospital Graubünden, Chur, Switzerland ; Dr. Risch Medical Laboratory, Sonic Suisse, Vaduz, Liechtenstein
Hansson, Lars-Olof; Department of Medical Sciencies, Clinical Chemistry, Uppsala University Hospital, Uppsala, Sweden
Price, Christopher P; Emeritus Professor in Clinical Biochemistry, Queen Mary, University of London, London, UK
Nyman, Ulf ; Department of Translational Medicine, Division of Medical Radiology, University of Lund, Malmö, Sweden
Björk, Jonas ; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden ; Clinical Studies Sweden - Forum South, Skåne University Hospital, Lund, Sweden
Delanaye, Pierre ; Université de Liège - ULiège > Département des sciences cliniques > Néphrologie ; Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
Bökenkamp, Arend ; Department of Paediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, The Netherlands
Christensson, Anders ; Department of Nephrology, Skåne University Hospital, Lund University, Malmö, Sweden
Grubb, Anders ; Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, Lund University, Lund, Sweden
Identification of cystatin C as a new marker of glomerular filtration rate, and of shrunken pore syndrome - a new kidney disorder defining selective glomerular hypofiltration syndromes - calls for expansion of the international KDIGO guidelines.
Publication date :
2025
Journal title :
Scandinavian Journal of Clinical and Laboratory Investigation
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