Obesity-induced glomerular hyperfiltration: its involvement in the pathogenesis of tubular sodium reabsorption

Chagnac, Avry; Herman, Michal; Zingerman, Boris; Erman, Arie; Rozen‐Zvi, Benaya; Hirsh, Judith; Gafter, Uzi

doi:10.1093/ndt/gfn379

Cited by 160 publications

(125 citation statements)

References 45 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, mean mGFR values obtained from microalbuminuric non-insulin-dependent diabetic patients are in about the same order of magnitude (9,21). However, apart from the normoglucose regulation and normal BP in the population with SS disease, another striking difference is a low filtration fraction in hyperfiltration SCAN (9,13), conversely to diabetic nephropathy and obesity-induced hyperfiltration (20,22), where the filtration fraction is higher than in healthy control subjects (9,20).…”

Section: Discussionmentioning

confidence: 94%

Glomerular Hyperfiltration in Adult Sickle Cell Anemia

Haymann¹,

Stankovic²,

Lévy³

et al. 2010

Clinical Journal of the American Society of Nephrology

143

144

View full text Add to dashboard Cite

Background and objectives: Sickle cell anemia-associated nephropathy is a growing matter of concern because renal failure affects most aging sickle cell anemia patients. Glomerular damage is a common feature revealed by a microalbuminuria or a macroalbuminuria. Although glomerular hyperfiltration has been described for decades in this population, its prevalence in young adults is unknown.Design, setting, participants, & measurements: To address this issue, as well as the clinical and biologic correlates of hyperfiltration, a single-center, cross-sectional study of 280 homozygous SS disease patients was performed.Results: The prevalence of hyperfiltration assessed by Modification of Diet in Renal Disease estimated GFR was 51%. Among patients with hyperfiltration, 49% had hyperfiltration alone, whereas 36% and 15% had an associated microalbuminuria or macroalbuminuria, respectively. Estimated GFR sensitivity and specificity for hyperfiltration were 94% and 63%, respectively, in a selected subgroup of 48 patients (measured GFR was assessed by urinary 51 Cr EDTA clearance). In patients with no albuminuria, hyperfiltration status was significantly associated with a young age (years), the absence of alpha thalassemia, a lower hemoglobin level (g/dl), and a lower fetal hemoglobin. The role of chronic hemolysis was further strengthened by multivariate analysis showing a correlation between estimated GFR and a low plasma fetal hemoglobin level, a young age, and a high reticulocyte count (r 2 ‫؍‬ 0.54). Conclusions: Together, the data suggest that the pathophysiology of hyperfiltration would rather be attributable to the hemolysis-associated vasculopathy rather than a viscosity-vaso-occlusive process.

show abstract

Section: Discussionmentioning

confidence: 94%

Glomerular Hyperfiltration in Adult Sickle Cell Anemia

Haymann¹,

Stankovic²,

Lévy³

et al. 2010

Clinical Journal of the American Society of Nephrology

143

144

View full text Add to dashboard Cite

show abstract

“…Obesity as such has been associated with hyperfiltration [32]. It has also been claimed that the metabolic syndrome is associated with hyperfiltration, as estimated by the Cockcroft-Gault formula [33].…”

Section: Hyperfiltration Independent Of Diabetesmentioning

confidence: 99%

The clinical significance of hyperfiltration in diabetes

et al. 2010

View full text Add to dashboard Cite

Glomerular filtration rate is commonly elevated in early diabetes and patients with this symptom are arbitrarily considered to have hyperfiltration. The prevalence of hyperfiltration in type 1 diabetes varies from less than 25% to more than 75%. The corresponding figures in type 2 diabetes are significantly lower, ranging between 0% and more than 40%. Several factors, methodological and biological, may contribute to the wide variation in estimates of hyperfiltration prevalence. Methodological differences in measurement and evaluation of GFR apply in particular to the handling of plasma disappearance curves of filtration markers. Biological factors that may influence GFR in the hyperfiltration range include glycaemic control, diabetes duration, BMI, sex, pubertal status in type 1 diabetes and age in type 2 diabetes. Hyperglycaemia may influence GFR and albuminuria, and may therefore confound the evaluation of hyperfiltration as an independent risk factor for diabetic nephropathy. Adequate assessment of the relationship between glycaemic control, GFR and AER therefore requires serial measurements of all three variables followed by multivariate analysis. A recent meta-analysis of ten type 1 diabetes studies concluded that the presence of hyperfiltration at baseline more than doubled the risk of developing micro-or macroalbuminuria at follow-up. However, not all studies allowed for confounding factors or regression dilution bias. Future studies will therefore need to address the independent role of hyperfiltration, not only in the evolution of albuminuria, but also in the subsequent decline of GFR.

show abstract

“…There are several reports examining the relationship between obesity and renal hemodynamic changes [3,5,6,8,[22][23][24][25][26]. However, the relationship between abdominal fat distribution and glomerular hyperfiltration and has not been studied to date.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Adipose Tissue was Associated with Glomerular Hyperfiltration among Non- Diabetic and Normotensive Adults with a Normal Body Mass Index

Lee

Kim

Cho

et al. 2015

Journal of Hypertension

View full text Add to dashboard Cite

Glomerular hyperfiltration is recognized as an early marker of progressive kidney dysfunction in the obese population. This study aimed to identify the relationship between glomerular hyperfiltration and body fat distribution measured by computed tomography (CT) in healthy Korean adults. The study population included individuals aged 20-64 years who went a routine health check-up including an abdominal CT scan. We selected 4,378 individuals without diabetes and hypertension. Glomerular filtration rate was estimated using the CKD-EPI equation, and glomerular hyperfiltration was defined as the highest quintile of glomerular filtration rate. Abdominal adipose tissue areas were measured at the level of the umbilicus using a 16-detector CT scanner, and the cross-sectional area was calculated using Rapidia 2.8 CT software. The prevalence of glomerular hyperfiltration increased significantly according to the subcutaneous adipose tissue area in men (OR = 1.74 (1.16-2.61), P for trend 0.016, for the comparisons of lowest vs. highest quartile) and visceral adipose tissue area in women (OR = 2.34 (1.46-3.75), P for trend < 0.001) in multivariate analysis. After stratification by body mass index (normal < 23 kg/m 2 , overweight 23 kg/m 2 ), male subjects with greater subcutaneous adipose tissue, even those in the normal BMI group, had a higher prevalence of glomerular hyperfiltration (OR = 2.11 (1.17-3.80), P for trend = 0.009). Among women, the significance of visceral adipose tissue area on glomerular hyperfiltration resulted from the normal BMI group (OR = 2.14 (1.31-3.49), P for trend = 0.002). After menopause, the odds ratio of the association of glomerular hyperfiltration with subcutaneous abdominal adipose tissue increased (OR = 2.96 (1.21-7.25), P for trend = 0.013). Subcutaneous adipose tissue areas and visceral adipose tissue areas are positively associated with glomerular hyperfiltration in healthy Korean adult men and women, PLOS ONE |

show abstract

Obesity-induced glomerular hyperfiltration: its involvement in the pathogenesis of tubular sodium reabsorption

Abstract: These results suggest that glomerular hyperfiltration may lead to increased proximal tubular sodium reabsorption in the obese.

Cited by 160 publications

References 45 publications

Glomerular Hyperfiltration in Adult Sickle Cell Anemia

Glomerular Hyperfiltration in Adult Sickle Cell Anemia

The clinical significance of hyperfiltration in diabetes

Abdominal Adipose Tissue was Associated with Glomerular Hyperfiltration among Non- Diabetic and Normotensive Adults with a Normal Body Mass Index

Contact Info

Product

Resources

About