The relationship between shrunken pore syndrome and all-cause mortality in people with type 2 diabetes and normal renal function: the Fremantle Diabetes Study Phase II
Authors' conclusion
A low eGFRcyst/eGFRcreat ratio is independently associated with mortality in type 2 diabetes, including in people without conventional markers of diabetic kidney disease. The presence of SPS may add clinical value to the risk assessment of people with type 2 diabetes regardless of renal status.
Study context
- Population
- Adults with T2D aged ≥17 years, Fremantle Diabetes Study Phase II; mean age 65.9 years, 51.8% male, median diabetes duration 9.0 years; subgroup with normal renal function (eGFRcreat ≥60 ml/min per 1.73 m² and urinary albumin/creatinine ratio <3 mg/mmol)of 1481 participants
- Participants
- 1,466 adults
- Exposure
- eGFRcyst/eGFRcreat ratio <0.60 vs higher ratio
- Outcome
- All-cause mortality
- Follow-up
- 10 years or until death
Methodological detailslongitudinal observational, community-based (Fremantle Diabetes Study Phase II)
- Longitudinal observational
- Community-based (Fremantle Diabetes Study Phase II)
Main finding
As reported in the abstract
10-year follow-up
Estimate (95% CI)P value
SPSvs Ratio ≥0.60most parsimonious Cox model
HR 1.56(1.07–2.29)
P = 0.021eGFRcyst/eGFRcreat ratio, per 0.1 increasecontinuous variable
aHR 0.91(0.85–0.97)
P = 0.004- Deaths during follow-up
- 384 (26.2%)
- Prevalence of eGFRcyst/eGFRcreat ratio <0.60 (shrunken pore syndrome (SPS))
- 10.4%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality, subgroup with normal renal function (n=754) · 10-year follow-upIndependent association | 2.55 (1.34–4.84) | P = 0.004 | |
| 0.20.5125Hazard ratio (log scale) |
- All-cause mortality, subgroup with normal renal function (n=754) — Deaths during follow-up
- 123 (16.3%)
- All-cause mortality, subgroup with normal renal function (n=754) — eGFRcyst/eGFRcreat ratio <0.60
- 57 (7.6%)
Original publication
The relationship between shrunken pore syndrome and all-cause mortality in people with type 2 diabetes and normal renal function: the Fremantle Diabetes Study Phase II. Diabetologia. Published 21 April 2025. doi:10.
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