Cystatin C-derived measures of renal function as risk factors for mortality and renal replacement therapy in the critically ill – An analysis of the SWECRIT cohort
Authors' conclusion
Our finding that SPS is more robustly associated with mortality in sepsis patients than in non-sepsis patients suggests that the association between SPS and mortality may depend on underlying pathophysiology. A cystatin C-based estimate of GFR is independently associated with RRT in sepsis and non-sepsis.
Study context
- Population
- Adults staying >24 h in four Swedish intensive care unit (ICUs), November 2015-December 2018 (SWECRIT cohort)32 % sepsis
- Participants
- 4,455 adults
- Exposure
- Cystatin C-derived measures (eGFRcys, shrunken pore syndrome) as risk factors in sepsis and non-sepsis ICU patients
- Outcome
- Mortality and need for RRT due to AKI
Methodological detailsmulticentre, four ICUs
- Multicentre
- Four ICUs
Main finding
As reported in the abstract
Adjusted associations (Cox regression)
Hazard ratio (95 % CI)P value
SPS vs no SPS1-year mortality, sepsis patients, adjusted
1.4(1.1–1.9)
P = 0.021eGFRcys <20 ml/min/1.73m2 vs eGFRcys ≥60 ml/min/1.73m2RRT, sepsis and non-sepsis patients, adjusted
3.1(1.6–6.0)
P < 0.001Observational data: associations, not effects.
Further findings
Prevalence of shrunken pore syndrome (SPS) and 90-day mortality (cohort)
%
- SPS present
- 7.4
- 90-day mortality
- 30.8
Original publication
Cystatin C-derived measures of renal function as risk factors for mortality and renal replacement therapy in the critically ill – An analysis of the SWECRIT cohort. J Crit Care. Published 14 May 2025. doi:10.
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