Selective glomerular hypofiltration syndrome: a novel renal phenotype associated with cardiovascular disease and adverse outcomes in diabetic kidney disease
Main finding · CVD prevalence at DKD diagnosisResult — go to the resultOdds ratio 9.27 95% CI 3.20–26.84Authors' conclusion
SGHS is independently associated with the prevalence of CVD at the time of DKD diagnosis, and independently predicts adverse renal outcomes in patients with DKD.
Study context
- Population
- Patients with biopsy-proven diabetic kidney disease (DKD)41 (22.5%) with selective glomerular hypofiltration syndrome (SGHS)
- Participants
- 182 patients
- Exposure
- SGHS vs no SGHS
- SGHSn = 41
- Outcome
- Prevalence of CVD at the time of renal biopsy-diagnosed DKD; long-term renal outcomes (DKD progression)
Methodological detailsbiopsy-proven DKD, nomogram, sensitivity analysis (SGHS redefined as ratio <0.70), subgroup analyses by gender and BMI
- Biopsy-proven DKD
- Nomogram
- Sensitivity analysis (SGHS redefined as ratio <0.70)
- Subgroup analyses by gender and BMI
Main finding
CVD prevalence at DKD diagnosis
Odds ratio
9.27
95% CI 3.20–26.84
P < 0.001
SGHSvs No SGHS
OR 9.27 (95% CI 3.20–26.84); P < 0.001
As reported in the abstract
- eGFRcys/eGFRcr ratio AUC for predicting cardiovascular disease (CVD)
- 0.730 (95% CI 0.643 to 0.816)
- eGFRcr AUC
- 0.602 (95% CI 0.507 to 0.697)
- eGFRcys AUC
- 0.701 (95% CI 0.615 to 0.786)
- eGFR based on creatinine and cystatin C AUC
- 0.685 (95% CI 0.595 to 0.774)
- Urinary albumin-to-creatinine ratio AUC
- 0.633 (95% CI 0.540 to 0.725)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| DKD progression · median follow-up 30.1 monthsSGHSvs No SGHS | 2.645 (1.564–4.472) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Log-rank test χ² | P value |
|---|---|---|
| DKD progression · median follow-up 30.1 monthsSGHS vs No SGHS · higher cumulative DKD progression probability with SGHS | 11.79 | P < 0.001 |
Nomogram incorporating SGHS for CVD
- AUC
- 0.834
- Bias-corrected C-index
- 0.808
- Good discrimination and calibration
Subgroup and sensitivity analyses
- Subgroup analyses and sensitivity analysis confirmed the robustness of findings
Original publication
Selective glomerular hypofiltration syndrome: a novel renal phenotype associated with cardiovascular disease and adverse outcomes in diabetic kidney disease. BMJ Open Diabetes Res Care. Published 17 September 2026. doi:10.
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