Glomerular filtration rate in Indian non-insulin-dependent diabetics at various stages of albuminuria

John, Lily; Mathews, Prasad; Oommnen, Regi

doi:10.1016/0168-8227(94)90019-1

Cited by 1 publication

(3 citation statements)

References 16 publications

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“…Previous reports suggest that the prevalence of hyperfiltration is higher in certain ethnic groups, such as Pima Indians, African-Americans, Asians and Polynesians, than in Caucasians [1,2,8,10,28,29]. However, in these ethnic groups diabetes occurs at an earlier age, and the prevalence rates may be affected by the age-unadjusted definition of hyperfiltration as discussed below.…”

Section: Discussionmentioning

confidence: 72%

“…The reported prevalence of hyperfiltration varies widely from 6 to 75%, with high rates documented in new-onset diabetes and in certain ethnic populations [2,[7][8][9][10][11][12]22]. The high rates of hyperfiltration in new-onset diabetes may be explained, at least partly, by the acute metabolic effect of hyperglycaemia, as previous studies have demonstrated an association between hyperglycaemia and hyperfiltration as well as nephromegaly [23,24].…”

Section: Discussionmentioning

confidence: 88%

“…In type 1 diabetes, hyperfiltration carries a 53% risk of developing overt nephropathy compared with 5% in normofiltering subjects over a 17-year period [6]. In comparison, information on the prevalence and pathogenic significance of hyperfiltration in type 2 diabetes is inconclusive and controversial, due to (1) difficulties in defining hyperfiltration in this population, (2) the co-existence of non-diabetic renal disease, (3) the diversity of patient characteristics, and (4) the insidious onset of the disease [2,[7][8][9][10][11][12]. Hyperfiltration in type 2 diabetes has been associated with a greater rate of decline in GFR than in normofiltering and non-diabetic control subjects over a 6-year period [13], but this finding is not universal [2].…”

Section: Introductionmentioning

confidence: 99%

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Renal hyperfiltration in type 2 diabetes: effect of age-related decline in glomerular filtration rate

et al. 2005

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Aims/hypothesis: 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. Materials and methods: GFR was measured in 662 type 2 diabetic patients by plasma disappearance of 99 m-technetium-diethylene-triaminepenta-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. Results: 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 ageunadjusted 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. Conclusions/interpretation: 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.

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