scholarly journals The Glycation Gap and Estimated Glomerular Filtration Rate in Individuals without Diabetes Mellitus

2014 ◽  
Vol 60 (10) ◽  
pp. 1346-1347 ◽  
Author(s):  
Kate Elizabeth Shipman ◽  
Mohammed Jawad ◽  
Katie Marie Sullivan ◽  
Clare Ford ◽  
Rousseau Gama
Keyword(s):  
Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate

scholarly journals Long-term prospective observation suggests that glomerular hyperfiltration is associated with rapid decline in renal filtration function: A multiethnic study

2018 ◽  
Vol 15 (5) ◽  
pp. 417-423 ◽  
Author(s):  
Serena Low ◽  
Xiao Zhang ◽  
Jiexun Wang ◽  
Lee Ying Yeoh ◽  
Yan Lun Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Odds Ratio ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Glomerular Hyperfiltration ◽  
Haemoglobin A1c ◽  
Baseline Haemoglobin

Aim: Glomerular hyperfiltration usually occurs early in development of kidney complications in diabetes. To understand hyperfiltration as a marker of renal disease progression in type 2 diabetes mellitus, we aimed to examine association between glomerular hyperfiltration (estimated glomerular filtration rate ⩾ 120 mL/min/1.73 m2) and rapid renal decline (annual estimated glomerular filtration rate loss ⩾ 3 mL/min/1.73 m2). Methods: This was a prospective cohort comprising 1014 patients with type 2 diabetes mellitus attending a Diabetes Centre of a regional hospital in 2002–2014. A separate prospective cohort, comprising 491 patients who attended Diabetes Centre or primary-care polyclinics, was used for validation. We performed binary mediation analysis to examine role of hyperfiltration on relationship between baseline haemoglobin A1c and rapid renal decline. Results: Among patients in discovery cohort, 5.2% had baseline hyperfiltration. Over mean follow-up of 6 years, 22.9% had rapid glomerular filtration rate decline. Baseline hyperfiltration was significantly associated with greater odds of rapid renal decline after adjusting for demographics, diabetes duration and clinical covariates (odds ratio: 2.57; 95% confidence interval: 1.21–5.46; p = 0.014). Similar finding was found in validation cohort (odds ratio: 2.98; 95% confidence interval: 1.06–8.42; p = 0.034). Hyperfiltration significantly accounted for 35.3% of association between increasing baseline haemoglobin A1c and rapid renal decline. Conclusion: Glomerular hyperfiltration is an independent risk factor of rapid renal decline. It mediates the association between increasing haemoglobin A1c and rapid renal decline.

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