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Deranged renal filtration of mid-sized (5–30 kDa) compared to smaller molecules (  0.9 (HR adj  1.6 [95% CI 1.1–2.5]). In elderly women eGFR cysC /eGFR crea  ratio &lt; 0.6 is common and associated with increased mortality. Our results confirm patient-based findings, suggesting that identifying individuals with SPS may be clinically relevant to assessing mortality risk in the elderly.

Impaired selective renal filtration captured by eGFRcysC/eGFRcrea ratio is associated with mortality in a population based cohort of older women