Glomerular Hyperfiltration Predicts Kidney Function Decline and Mortality in Type 1 and Type 2 Diabetes: A 21-Year Longitudinal Study
Authors' conclusion
Glomerular hyperfiltration, similar to hypofiltration, increases the combined risk of worsening kidney function and mortality from cardiovascular or renal causes in patients with diabetes. These findings encourage the active screening of these patients to optimize risk stratification and treatment of subclinical kidney disease.
Study context
- Population
- Patients with long-standing T1D or T2D
- Participants
- 314 patients
- Exposure
- High or low measured GFR vs normal measured GFR
- High mGFR (H-mGFR)n = 63
- Low mGFR (L-mGFR)n = 63
- Normal mGFR (N-mGFR)n = 188reference
- Outcome
- Composite of:
- Doubling of serum creatinine
- End-stage kidney disease (ESKD)
- Cardiorenal death
- Follow-up
- Median 21.0 years
Methodological detailslongitudinal, 21-year follow-up
- Longitudinal
- 21-year follow-up
Main finding
As reported in the abstract
Primary composite outcome
Each group vs N-mGFRHazard ratio (95% CI)
H-mGFR
2.09(1.25–3.49)
L-mGFR
1.81(1.05–3.16)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Kidney-specific composite (doubling of serum creatinine, ESKD or renal death)H-mGFRvs N-mGFR | 4.95 (2.21–11.09) | |
| Kidney-specific composite (doubling of serum creatinine, ESKD or renal death)L-mGFRvs N-mGFR | 3.81 (1.70–8.56) | |
| Doubling of serum creatinineH-mGFRvs N-mGFR | 4.86 (2.18–10.90) | |
| Doubling of serum creatinineL-mGFRvs N-mGFR | 4.04 (1.77–9.20) | |
| Cardiorenal deathH-mGFRvs N-mGFR | 2.18 (1.24–3.83) | |
| Cardiorenal deathL-mGFRvs N-mGFR | 2.26 (1.27–4.01) | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Glomerular Hyperfiltration Predicts Kidney Function Decline and Mortality in Type 1 and Type 2 Diabetes: A 21-Year Longitudinal Study. Diabetes Care. Published 14 February 2023. doi:10.
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