TY - JOUR

T1 - Renal hyperfiltration as a novel marker of all-cause mortality

AU - Park, Minseon

AU - Yoon, Eunsil

AU - Lim, Youn-Hee

AU - Kim, Ho

AU - Choi, Jinwook

AU - Yoon, Hyung-Jin

N1 - Copyright © 2015 by the American Society of Nephrology.

PY - 2015

Y1 - 2015

N2 - Although renal hyperfiltration (RHF) or an abnormal increase in GFR has been associated with many lifestyles and clinical conditions, including diabetes, its clinical consequence is not clear. RHF is frequently considered to be the result of overestimating true GFR in subjects with muscle wasting. To evaluate the association between RHF and mortality, 43,503 adult Koreans who underwent voluntary health screening at Seoul National University Hospital between March of 1995 and May of 2006 with baseline GFR≥60 ml/min per 1.73 m(2) were followed up for mortality until December 31, 2012. GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and RHF was defined as GFR>95th percentile after adjustment for age, sex, muscle mass, and history of diabetes and/or hypertension medication. Muscle mass was measured with bioimpedance analysis at baseline. During the median follow-up of 12.4 years, 1743 deaths occurred. The odds ratio of RHF in participants with the highest quartile of muscle mass was 1.31 (95% confidence interval [95% CI], 1.11 to 1.54) compared with the lowest quartile after adjusting for confounding factors, including body mass index. The hazard ratio of all-cause mortality for RHF was 1.37 (95% CI, 1.11 to 1.70) by Cox proportional hazards model with adjustment for known risk factors, including smoking. These data suggest RHF may be associated with increased all-cause mortality in an apparently healthy population. The possibility of RHF as a novel marker of all-cause mortality should be confirmed.

AB - Although renal hyperfiltration (RHF) or an abnormal increase in GFR has been associated with many lifestyles and clinical conditions, including diabetes, its clinical consequence is not clear. RHF is frequently considered to be the result of overestimating true GFR in subjects with muscle wasting. To evaluate the association between RHF and mortality, 43,503 adult Koreans who underwent voluntary health screening at Seoul National University Hospital between March of 1995 and May of 2006 with baseline GFR≥60 ml/min per 1.73 m(2) were followed up for mortality until December 31, 2012. GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and RHF was defined as GFR>95th percentile after adjustment for age, sex, muscle mass, and history of diabetes and/or hypertension medication. Muscle mass was measured with bioimpedance analysis at baseline. During the median follow-up of 12.4 years, 1743 deaths occurred. The odds ratio of RHF in participants with the highest quartile of muscle mass was 1.31 (95% confidence interval [95% CI], 1.11 to 1.54) compared with the lowest quartile after adjusting for confounding factors, including body mass index. The hazard ratio of all-cause mortality for RHF was 1.37 (95% CI, 1.11 to 1.70) by Cox proportional hazards model with adjustment for known risk factors, including smoking. These data suggest RHF may be associated with increased all-cause mortality in an apparently healthy population. The possibility of RHF as a novel marker of all-cause mortality should be confirmed.

KW - Adult

KW - Age Factors

KW - Aged

KW - Anthropometry

KW - Body Mass Index

KW - Cause of Death

KW - Comorbidity

KW - Female

KW - Glomerular Filtration Rate

KW - Humans

KW - Incidence

KW - Kidney Glomerulus/metabolism

KW - Life Style

KW - Male

KW - Mass Screening/methods

KW - Middle Aged

KW - Odds Ratio

KW - Proportional Hazards Models

KW - Renal Insufficiency, Chronic/mortality

KW - Republic of Korea

KW - Retrospective Studies

KW - Risk Factors

KW - Severity of Illness Index

KW - Sex Factors

KW - Smoking/epidemiology

KW - Survival Analysis

U2 - 10.1681/ASN.2014010115

DO - 10.1681/ASN.2014010115

M3 - Journal article

C2 - 25343954

VL - 26

SP - 1426

EP - 1433

JO - Journal of the American Society of Nephrology : JASN

JF - Journal of the American Society of Nephrology : JASN

SN - 1046-6673

IS - 6

ER -