Impaired Fasting Glucose Is Associated With Renal Hyperfiltration in the General Population

Melsom, Toralf; Mathisen, Ulla Dorte; Ingebretsen, Ole C.; Jenssen, Trond; Njølstad, Inger; Solbu, Marit Dahl; Toft, Ingrid; Eriksen, Bjørn Odvar

doi:10.2337/dc11-0235

Cited by 117 publications

(128 citation statements)

References 24 publications

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“…12 Glomerular hyperfiltration has been established as an early manifestation of diabetic nephropathy and has been shown to predict albuminuria and GFR decline in diabetes. 13,14 Hyperfiltration is also a possible common causal pathway for other causes of CKD; however, the longitudinal association between prediabetes and hyperfiltration remains to be established.…”

Section: Discussionmentioning

confidence: 99%

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Melsom

Schei

Stefansson

et al. 2016

American Journal of Kidney Diseases

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Section: Discussionmentioning

confidence: 99%

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Melsom

Schei

Stefansson

et al. 2016

American Journal of Kidney Diseases

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“…Therefore, the age factor and muscle mass should be considered when defining higher GFR or RHF. Melsom et al 19 proposed an age-and body size-adjusted definition of RHF on the basis of measured GFR and observed an association between RHF and impaired fasting glucose in a cross-sectional study. However, direct measurement of GFR may be impractical in a clinical or epidemiologic setting.…”

Section: Discussionmentioning

confidence: 99%

“…19 Briefly, the residuals were calculated from a multiple linear regression analysis, where logarithm-transformed eGFR was a dependent variable and sex, LBM, previous history of medication for diabetes and/or hypertension, and logarithm-transformed age were independent variables. An additive multivariate Cox regression model was used to compute pointwise estimates and CIs of aHR curves of mortality associated with the percentile rank of the residuals of eGFR after controlling for age, sex, smoking status, regular alcohol consumption, regular exercise, previous history of diabetes and/or hypertension medication, BMI, systolic BP, FSG, serum HDLcholesterol, serum triglyceride, and albuminuria.…”

Section: Setting and Participantsmentioning

confidence: 99%

“…Because both muscle mass and GFR decrease as age increases, both age and muscle mass should be considered in the definition of high GFR or RHF. [18][19][20] In addition, cigarette smoking-one of the most important risk factors for mortality-has been associated with RHF. 7 The differential effect of smoking on the association between RHF and mortality should be evaluated.…”

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confidence: 99%

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Renal Hyperfiltration as a Novel Marker of All-Cause Mortality

Park

Yoon

Lim

et al. 2015

Journal of the American Society of Nephrology

115

136

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Although renal hyperfiltration (RHF) or an abnormal increase in GFR has been associated with many lifestyles and clinical conditions, including diabetes, its clinical consequence is not clear. RHF is frequently considered to be the result of overestimating true GFR in subjects with muscle wasting. To evaluate the association between RHF and mortality, 43,503 adult Koreans who underwent voluntary health screening at Seoul National University Hospital between March of 1995 and May of 2006 with baseline GFR$60 ml/min per 1.73 m 2 were followed up for mortality until December 31, 2012. GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and RHF was defined as GFR.95th percentile after adjustment for age, sex, muscle mass, and history of diabetes and/or hypertension medication.Muscle mass was measured with bioimpedance analysis at baseline. During the median follow-up of 12.4 years, 1743 deaths occurred. The odds ratio of RHF in participants with the highest quartile of muscle mass was 1.31 (95% confidence interval [95% CI], 1.11 to 1.54) compared with the lowest quartile after adjusting for confounding factors, including body mass index. The hazard ratio of all-cause mortality for RHF was 1.37 (95% CI, 1.11 to 1.70) by Cox proportional hazards model with adjustment for known risk factors, including smoking. These data suggest RHF may be associated with increased all-cause mortality in an apparently healthy population. The possibility of RHF as a novel marker of all-cause mortality should be confirmed. Although CKD is a well known risk factor for all-cause or cardiovascular mortality, 1 the clinical consequences of an abnormally high GFR or renal hyperfiltration (RHF) have not been adequately evaluated. On the basis of several cross-sectional studies, RHF is known to be associated with various medical conditions, such as diabetes, 2,3 hypertension, 4 obesity, 5 prehypertension, and prediabetes, 6 as well as lifestyle factors, such as smoking, 7 lack of physical activity, 8 and low aerobic fitness. 9 Although these conditions are well known risk factors for early mortality, 10 the clinical implications of RHF remain unclear.Several cohort studies and meta-analyses have reported a J-shaped association between GFR and all-cause and cardiovascular mortality. However, the increased mortality associated with a higher GFR was commonly regarded as an overestimation of GFR because of muscle wasting in a high-risk group. [11][12][13][14][15][16][17] The disappearance of the J-shaped association between GFR and mortality within a younger age group in the higher GFR range is considered as supporting evidence for the overestimation of the true GFR

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“…Second, hyperfiltration by mGFR or urinary creatinine clearance is associated with CKD risk factors and complications (obesity, diabetes, hypertension, left ventricular hypertrophy) (20)(21)(22)(23)(24), with developing albuminuria (25)(26)(27)(28), with structural abnormalities in the kidney (cysts, enlarged kidneys, and decreased glomerular density) (29)(30)(31)(32)(33), and with subsequent GFR decline and ESRD (29,34,35). Although eGFR Cr also identifies hyperfiltration as an increasedrisk state (16,24,28,35,36), eGFR Cys identifies hyperfiltration as a low-risk state (Figure 3) (16,23,24,35).…”

Section: The Non-gfr Determinants Of Egfr Are a Problemmentioning

confidence: 99%

GFR Estimating Equations

Rule

Glassock

2013

Clinical Journal of the American Society of Nephrology

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SummaryThe application of serum creatinine and cystatin C in patients with CKD has been limited to using estimated glomerular filtration rate (eGFR). Criteria for choosing the best GFR estimating equation are 1) accuracy in estimating measured GFR, 2) optimal discrimination of clinical outcomes, and 3) association with CKD risk factors and outcomes similar to that of measured GFR. Notably, these criteria are often not in agreement; and while the last criterion is the most important, it has been widely overlooked. The primary problem with eGFR is that the non-GFR determinants of serum creatinine and cystatin C, as well as their surrogates (age, sex, and race), associate with CKD risk factors and outcomes. This leads to a distorted understanding of CKD, though eGFR based on serum creatinine appears to be less biased than eGFR based on cystatin C. Because of this problem, the use of eGFR should be limited to settings where knowing actual GFR is relevant and eGFR is more informative about GFR than serum creatinine or cystatin C alone. Such settings include staging CKD severity by GFR and dosing medications cleared by glomerular filtration. Alternatively, the diagnosis of CKD, the longitudinal progression of CKD, and prognostic models for CKD are settings where serum creatinine and cystatin C can be better applied and interpreted without eGFR.

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Impaired Fasting Glucose Is Associated With Renal Hyperfiltration in the General Population

Cited by 117 publications

References 24 publications

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Prediabetes and Risk of Glomerular Hyperfiltration and Albuminuria in the General Nondiabetic Population: A Prospective Cohort Study

Renal Hyperfiltration as a Novel Marker of All-Cause Mortality

GFR Estimating Equations

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