Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/18597
Title: Hyperfiltration in Indigenous Australians with and without diabetes.
Authors: Ekinci, Elif I;Hughes, Jaquelyne T;Chatfield, Mark D;Lawton, Paul D;Jones, Graham R D;Ellis, Andrew G;Cass, Alan;Thomas, Mark;MacIsaac, Richard J;O'Dea, Kerin;Jerums, George;Maple-Brown, Louise J
Affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia
School of Population Health, University of South Australia, Adelaide, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
SydPath, St Vincent's Hospital, Sydney, Australia
Royal Perth Hospital, Perth, Australia
Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne and the University of Melbourne, Melbourne, Australia
Issue Date: Nov-2015
EDate: 2015-07-03
Citation: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2015; 30(11): 1877-84
Abstract: Hyperfiltration (HF) has been linked to the development of diabetic kidney disease (DKD), but the causative or predictive role of HF in the pathogenesis of DKD still remains unclear. To date, there have been no studies of HF in Indigenous Australians, a population with high rates of both diabetes and end-stage kidney disease. We aimed to compare the characteristics and frequency of HF in Indigenous Australians with and without type 2 diabetes. Indigenous Australian participants, recruited across five pre-defined strata of health, diabetes status and kidney function, had a reference glomerular filtration rate (GFR) measured using plasma disappearance of iohexol [measured GFR(mGFR)] over 4 h. HF was defined in various ways: (i) mGFR > 144 mL/min/1.73 m(2), which is mGFR > 1.96 × SD above the mean of the mGFR in non-diabetic participants with normal albuminuria and normal renal function (mGFR > 90 mL/min/1.73 m(2)); (ii) age-corrected mGFR (>144 mL/min/1.73 m(2)) to account for the effect of ageing on GFR in subjects over 40 years of age with cut-off 1 mL/min/1.73 m(2) lower for every year; (iii) mGFR > 144 mL/min, without correction for body surface area or age, as well as (iv) mGFR > 125 mL/min/1.73 m(2), without adjustment for age. A total of 383 Indigenous participants, 125 with and 258 without diabetes, with mGFR > 90 mL/min/1.73 m(2) were studied. The proportion of participants with HF was 7% using mGFR > 144 mL/min/1.73 m(2), 11% using the age-adjusted definition, 19% using mGFR > 144 mL/min and 27% using mGFR > 125 mL/min/1.73 m(2). Diabetes was more common in participants with HF (40-74%) compared with normofiltering participants (28-31%), regardless of the definition of HF. HF exists in Indigenous Australians with and without diabetes. A greater proportion of participants had diabetes in HF group compared with normofiltration group. Long-term follow-up of this cohort is necessary to determine if HF plays a role in the development of DKD and non-DKD.
URI: http://ahro.austin.org.au/austinjspui/handle/1/18597
DOI: 10.1093/ndt/gfv230
ORCID: 0000-0003-2372-395X
PubMed URL: 26142395
Type: Journal Article
Research Support, Non-U.S. Gov't
Subjects: CKD-EPI equation
diabetic kidney disease
ethnicity
glomerular filtration rate
hyperfiltration
Appears in Collections:Journal articles

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