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Increased risk of glomerular hyperfiltration in subjects with impaired glucose tolerance and newly diagnosed diabetes.
Nephrol Dial Transplant 2016; 31(8):1295-301ND

Abstract

BACKGROUND

Glomerular hyperfiltration is closely related to diabetes and may lead to subsequent nephropathy, but the association between glomerular hyperfiltration and prediabetic state is unclear. We examined the relationship of different glycemic statuses, including normal glucose tolerance (NGT), isolated impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and newly diagnosed diabetes (NDD), with glomerular hyperfiltration.

METHODS

This study included 12 833 subjects ≥20 years of age without a history of renal disease, cancer, moderate/severe anemia or diabetes and taking medications for hypertension, diabetes, hyperlipidemia or cardiovascular disease from National Cheng Kung University Hospital between January 2000 and August 2009. Hyperfiltration was defined as an estimated GFR (eGFR) above the age- and gender-specific 95th percentile for apparently healthy subjects, while hypofiltration was defined as an eGFR below the 5th percentile. eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration equation.

RESULTS

After further excluding hypofiltration and adjusting for available confounders, fasting plasma glucose (FPG), 2-hour postload glucose (2hPG), 2hPG-FPG (fluctuating blood glucose), HbA1c (average blood glucose), NDD and IGT but not isolated IFG were significantly associated with increased eGFR and a higher risk of hyperfiltration {NDD: odds ratio [OR] 1.97 [95% confidence interval (CI), 1.48-2.64], P < 0.001; IGT: OR 1.34 (95% CI 1.07-1.66), P = 0.009}.

CONCLUSIONS

High glucose states increase hyperfiltration risk. In addition to newly diagnosed diabetes, excessively high GFR also deserves attention in subjects with IGT.

Authors+Show Affiliations

Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China.Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan, Republic of China Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

26610595

Citation

Sun, Zih-Jie, et al. "Increased Risk of Glomerular Hyperfiltration in Subjects With Impaired Glucose Tolerance and Newly Diagnosed Diabetes." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 31, no. 8, 2016, pp. 1295-301.
Sun ZJ, Yang YC, Wu JS, et al. Increased risk of glomerular hyperfiltration in subjects with impaired glucose tolerance and newly diagnosed diabetes. Nephrol Dial Transplant. 2016;31(8):1295-301.
Sun, Z. J., Yang, Y. C., Wu, J. S., Wang, M. C., Chang, C. J., & Lu, F. H. (2016). Increased risk of glomerular hyperfiltration in subjects with impaired glucose tolerance and newly diagnosed diabetes. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 31(8), pp. 1295-301. doi:10.1093/ndt/gfv385.
Sun ZJ, et al. Increased Risk of Glomerular Hyperfiltration in Subjects With Impaired Glucose Tolerance and Newly Diagnosed Diabetes. Nephrol Dial Transplant. 2016;31(8):1295-301. PubMed PMID: 26610595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased risk of glomerular hyperfiltration in subjects with impaired glucose tolerance and newly diagnosed diabetes. AU - Sun,Zih-Jie, AU - Yang,Yi-Ching, AU - Wu,Jin-Shang, AU - Wang,Ming-Cheng, AU - Chang,Chih-Jen, AU - Lu,Feng-Hwa, Y1 - 2015/11/25/ PY - 2015/06/22/received PY - 2015/10/12/accepted PY - 2015/11/28/entrez PY - 2015/11/28/pubmed PY - 2017/9/14/medline KW - chronic kidney disease KW - glomerular hyperfiltration KW - impaired fasting glucose KW - impaired glucose tolerance KW - prediabetes SP - 1295 EP - 301 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 31 IS - 8 N2 - BACKGROUND: Glomerular hyperfiltration is closely related to diabetes and may lead to subsequent nephropathy, but the association between glomerular hyperfiltration and prediabetic state is unclear. We examined the relationship of different glycemic statuses, including normal glucose tolerance (NGT), isolated impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and newly diagnosed diabetes (NDD), with glomerular hyperfiltration. METHODS: This study included 12 833 subjects ≥20 years of age without a history of renal disease, cancer, moderate/severe anemia or diabetes and taking medications for hypertension, diabetes, hyperlipidemia or cardiovascular disease from National Cheng Kung University Hospital between January 2000 and August 2009. Hyperfiltration was defined as an estimated GFR (eGFR) above the age- and gender-specific 95th percentile for apparently healthy subjects, while hypofiltration was defined as an eGFR below the 5th percentile. eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS: After further excluding hypofiltration and adjusting for available confounders, fasting plasma glucose (FPG), 2-hour postload glucose (2hPG), 2hPG-FPG (fluctuating blood glucose), HbA1c (average blood glucose), NDD and IGT but not isolated IFG were significantly associated with increased eGFR and a higher risk of hyperfiltration {NDD: odds ratio [OR] 1.97 [95% confidence interval (CI), 1.48-2.64], P < 0.001; IGT: OR 1.34 (95% CI 1.07-1.66), P = 0.009}. CONCLUSIONS: High glucose states increase hyperfiltration risk. In addition to newly diagnosed diabetes, excessively high GFR also deserves attention in subjects with IGT. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/26610595/Increased_risk_of_glomerular_hyperfiltration_in_subjects_with_impaired_glucose_tolerance_and_newly_diagnosed_diabetes_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfv385 DB - PRIME DP - Unbound Medicine ER -