Shrunken pore syndrome increased the risk of acute kidney injury after cardiac surgery: a cohort study
In brief
Shrunken pore syndrome linked to AKI in one third of CABG patients
In a cohort of 1,277 adults undergoing isolated coronary bypass, 12.8% had shrunken pore syndrome and 33.5% of them developed acute kidney injury, compared with 21.7% without the syndrome-a roughly 50% relative increase. The finding persisted after matching and adjustment, suggesting SPS could help identify patients at higher postoperative renal risk, though prospective validation is needed.
- Journal
- Annals of medicine (Q1)
- Published
- 26 August 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Qian Zhang, Wenjie Zhu, Shiyu Hu, Hong Lu, Xincheng Gu, Linming Zhang, et al.
- PMID
- 42644296
- DOI
- 10.1080/07853890.2026.2722717
Why clinicians should know about it
- Picked for Nephrology (paper of the day, 1 September 2026): Shrunken pore syndrome predicts AKI after CABG
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.