Tạp Chí Y Học Việt Nam · Aug 13, 2026
ASSOCIATION BETWEEN SERUM ALBUMIN AND HOMOCYSTEINE WITH SHRUNKEN PORE SYNDROME (SPS)
By Bùi ĐMB, Lê QT
BACKGROUND: Estimated glomerular filtration rate based on creatinine can be biased by non-renal factors. Cystatin C provides a method with less interference. The term "Shrunken Pore Syndrome (SPS)" is characterized by a selective reduction in the filtration of medium-sized molecules and is strongly associated with cardiovascular mortality. This study aims to determine the biochemical factors associated with the discrepancy between the two eGFR estimation methods in shrunken pore syndrome in Vietnam. METHODS: A cross-sectional study on 233 chronic kidney disease patients at the Outpatient Department, University Medical Center Ho Chi Minh City - Campus 2. Four regression models were used to analyze the variables: filtration rate difference (diffcreacys = eGFRcrea - eGFRcysC), eGFR difference (when |diffcreacys| >= 15), filtration rate ratio (eGFRcysC/eGFRcrea), and SPS status (defined as eGFRcysC/eGFRcrea < 0.7). Independent variables included sex, age, serum albumin, homocysteine, LDL-C, HbA1c, and BMI. Data were analyzed using Stata software. RESULTS: Females had a significantly lower eGFRcysC/eGFRcrea ratio compared to males ( = -0.103, p < 0.001). Advanced age increased the risk of pore shrinkage ( = -0.0026, p < 0.05). High serum albumin levels were associated with an increased eGFRcysC/eGFRcrea ratio ( = 0.138, p < 0.001) and decreased diffcreacys ( = 5.51, p = 0.001). Homocysteine was associated with the filtration rate difference diffcreacys (OR = 0.92, p < 0.05), whereas LDL-C showed a weak association with the filtration rate ratio ( = 0.0006, p < 0.05). CONCLUSIONS: The difference between the two eGFR estimation methods may reflect pathology at the filtration membrane rather than mere calculation error. Females and the elderly are sensitive groups to SPS. Serum albumin and homocysteine may serve as factors associated with the presence of shrunken pore syndrome. SPS may explain the elevated cardiovascular risk through the accumulation of atherogenic proteins. Therefore, both eGFR indices should be evaluated concurrently in female and elderly patient groups to avoid missing latent cardiovascular risks.