Please use this identifier to cite or link to this item:
Title: Renal hyperfiltration in type 2 diabetes: effect of age-related decline in glomerular filtration rate.
Authors: Premaratne, Erosha;Macisaac, Richard J;Tsalamandris, Con;Panagiotopoulos, Sianna;Smith, T;Jerums, George
Affiliation: Endocrinology Unit, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 1-Nov-2005
Citation: Diabetologia 2005; 48(12): 2486-93
Abstract: We sought to characterise the effect of the age-related decline of GFR on hyperfiltration in type 2 diabetes and to identify clinical characteristics associated with hyperfiltration.GFR was measured in 662 type 2 diabetic patients by plasma disappearance of 99 m-technetium-diethylene-triamine-penta-acetic acid. The prevalence of hyperfiltration was calculated using both an age-unadjusted GFR threshold of >130 ml min(-1) 1.73 m(-2) and an age-adjusted threshold incorporating a decline of 1 ml min(-1) year(-1) after the age of 40. The hyperfiltering patients were compared with type 2 diabetic subjects who had a GFR between 90 and 130 ml min(-1) 1.73 m(-2) and were matched for age, sex and disease duration to allow for identification of modifiable factors associated with hyperfiltration.The prevalence of hyperfiltration was 7.4% when age-unadjusted and 16.6% when age-adjusted definitions were used. The age-unadjusted vs -adjusted prevalence rates for hyperfiltration were 50 vs 50%, 12.9 vs 23.4% and 0.3 vs 9.0% for patients aged <40 years, 40 to 65 years and >65 years, respectively. Both the age-unadjusted and -adjusted hyperfiltration groups had lower mean diastolic blood pressure and lower serum creatinine levels than the control groups. Although the age-unadjusted hyperfiltration group had larger kidneys compared to the control group, this difference was no longer significant when the age-adjusted definition was used. There were no differences in HbA(1)c, mean arterial pressure, antihypertensive use, insulin therapy, dyslipidaemia, frequency of macro- or microvascular complications, BMI, urinary sodium, urea and albumin excretion between the groups.Hyperfiltration was still more common among younger patients with type 2 diabetes even after adjusting for the expected age-related decline in GFR. Hyperfiltration was associated with a lower mean diastolic blood pressure independent of age.
Internal ID Number: 16261309
DOI: 10.1007/s00125-005-0002-9
ORCID: 0000-0002-0845-0001
Type: Journal Article
Subjects: Adult
Aged, 80 and over
Blood Pressure.physiology
Cohort Studies
Diabetes Mellitus, Type 2.blood.physiopathology
Diabetic Nephropathies.blood.epidemiology.physiopathology
Glomerular Filtration Rate.physiology
Middle Aged
Appears in Collections:Journal articles

Files in This Item:
File Description SizeFormat 
16261309.pdf205.19 kBAdobe PDFThumbnail

Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.