Glomerular hyperfiltration

Cortinovis, Monica; Perico, Norberto; Ruggenenti, Piero; Remuzzi, Andrea; Remuzzi, Giuseppe

doi:10.1038/s41581-022-00559-y

Cited by 101 publications

(82 citation statements)

References 258 publications

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“…The increase in glomerular capillary hydraulic pressure, causes stretch in the capillary wall, and creates tensile stress and shear stress, leading to changes in the glomerular basement membrane that aggravate over time. Other factors also contribute to glomerular damage ( Cortinovis et al, 2022 ). Together with glomerular enlargement, renal hypertrophy was observed in both the FF and FW groups, as evidenced by the increase in the renal cross-sectional area.…”

Section: Discussionmentioning

confidence: 99%

Effects of maternal fructose intake on the offspring’s kidneys

et al. 2022

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Fructose overload is associated with cardiovascular and metabolic disorders. During pregnancy, these alterations may affect the maternal environment and predispose offspring to diseases. Aims: To evaluate the renal morphology and function of offspring of dams that received fructose overload during pregnancy and lactation. Methods: Female Wistar rats were divided into the control (C) and fructose (F) groups. C received food and water ad libitum, and F received food and d-fructose solution (20%) ad libitum. The d-fructose offer started 1 week before mating and continued during pregnancy and lactation. The progeny were designated as control (C) or fructose (F); after weaning, half of the F received water to drink (FW), and half received d-fructose (FF). Blood pressure (BP) and renal function were evaluated. The expression of sodium transporters (NHE3-exchanger, NKCC2 and NCC-cotransporters, and ENaC channels) and markers of renal dysfunction, including ED1 (macrophage), eNOS, 8OHdG (oxidative stress), renin, and ACE 1 and 2, were evaluated. CEUA-UNIFESP: 2757270117. The FF group presented with reduced glomerular filtration rate and urinary osmolarity, increased BP, proteinuria, glomerular hypertrophy, macrophage infiltration, and increased expression of transporters (NHE3, NCC, and ENaC), 8OHdG, renin, and ACE1. The FW group did not show increased BP and renal functional alterations; however, it presented glomerular hypertrophy, macrophage infiltration, and increased expression of the transporters (NHE3, NKCC2, NCC, and ENaC), renin, and ACE1. These data suggest that fructose overload during fetal development alters renal development, resulting in the increased expression of renin, ACE1, and sodium transporters, thus predisposing to hypertension and renal dysfunction.

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Section: Discussionmentioning

confidence: 99%

Effects of maternal fructose intake on the offspring’s kidneys

et al. 2022

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“…Cortinovis et al 13 mentioned that the GFR increased during pregnancy due to absolute hyper ltration. Porrini et al 14 revealed that more than 70 formulae used for estimating GFR had large errors, which did not improve over the past 60 years.…”

Section: Ri Of Gw-speci C Egfrmentioning

confidence: 99%

“…Comparative analyses among the estimated glomerular ltration rates (eGFRs) derived from the gestational eGFR equation (GEF) using others. Others are the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation 12 , modi ed Modi cation of Diet in Renal Disease (mMDRD) equation 13 , and Nanra equation 14 .…”

Section: Declarations Data Availabilitymentioning

confidence: 99%

Development of a real-time reporting system of the reference interval for gestational serum creatinine and estimated glomerular filtration rate using machine learning

Ahn

Lee

et al. 2022

Preprint

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The evaluation of maternal serum creatinine (SCr) concentrations according to gestational week (GW)-specific reference intervals (RIs) could be helpful in predicting adverse pregnancy outcomes. From January 2010 to December 2020, 1,370 SCr measurements from 940 normal pregnant women were collected from electronic medical records. Data should be processed using the bootstrap resampling method as most of the sample sizes according to GW were too small for obtaining the RIs. To enable resampling, the GWs were divided into 12 gestational periods (GPs). Implementation of resampling, determination of the appropriateness of RIs from the resampled new datasets in every GP, and establishment of GW-specific SCr RI using polynomial regression model analysis of GP-specific SCr RIs were performed using machine learning techniques. As 100 means from two resampled SCr measurements without replacement were made at every GP, 1,200 resampled results were used for developing RIs. The regression equations used for calculating the upper and lower limit of GW-specific SCr RIs were y = 88.8 − 3.75x + 0.141x2 − 0.00157x3 and y = 42.3 − 1.48x + 0.0321x2, respectively. Gestational estimated glomerular filtration rate (eGFR) was defined as the rate of SCr hyperfiltration. The median regression equation for GW-specific eGFR RI was y = 99 + 5.71x − 0.184x2 + 0.00166x3, while the calculation process of SCr hyperfiltration at any GW was added to develop the gestational eGFR formula (GEF). As GW-specific SCr RI and eGFR by GEF with GW-specific eGFR RIs were reported in the laboratory information system in real time, this clinical application can be used as a screening tool for predicting the adverse pregnancy outcomes.

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“…Chronic kidney disease in developing countries also tends to be present in younger people who are unaware of their underlying kidney disease, and very few receive optimal care because of resource constraints (13, 14). Regardless of the underlying cause of CKD, most kidney diseases progress to ESKD due to irreversible nephron loss leading to premature death (15, 16). Slowing CKD progression, promoting remission, or even regression of CKD, have been based on the control of blood pressure, control of blood sugar, reduction of proteinuria and management of other known risk factors for CKD progression (17, 18).…”

Section: Introductionmentioning

confidence: 99%

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

Meremo

Paget

Duarte

et al. 2022

Preprint

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Background: Chronic kidney disease (CKD) is a major public health issue worldwide and is an important contributor to the overall non-communicable disease burden. Chronic kidney disease is usually asymptomatic, and insidiously and silently progresses to advanced stages in resource limited settings. Methodology: A prospective longitudinal study was carried out on black patients with CKD attending the kidney outpatient clinic at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa, between September 2019 to March 2022. Demographic and clinical data were extracted from the ongoing continuous clinic records, as well as measurements of vital signs and interviews at baseline and at follow up. Patients provided urine and blood samples for laboratory investigations as standard of care at study entry (0) and at 24 months, and were followed up prospectively for two (2) years. Data were descriptively and inferentially entered into REDcap and analysed using STATA version 17, and multivariable logistic regression analysis was used to identify predictors of CKD progression. Results: A total of 312 patients were enrolled into the study, 297 (95.2%) patients completed the study, 10 (3.2%) patients were lost to follow and 5 (1.6%) patients died during the study period. The prevalence of CKD progression was 49.5%, while that of CKD remission was 33% and CKD regression was 17.5%. For patients with CKD progression the median age at baseline was 58 (46 - 67) years, the median eGFR was 37 (32 -51) mL/min/1.73 m2, median urine protein creatinine ratio (uPCR) was 0.038 (0.016 -0.82) g/mmol and the median haemoglobin (Hb) was 13.1 (11.7 – 14.4) g/dl; 95.2% had hypertension, 40.1% patients had diabetes mellitus and 39.5% had both hypertension and diabetes mellitus. Almost half (48.3%) of patients with CKD progression had severely increased proteinuria and 45.6% had anaemia. Variables associated with higher odds for CKD progression after multivariable logistic regression analysis were severely increased proteinuria (OR 32.3, 95 % CI 2.8 - 368.6, P = 0.005), moderately increased proteinuria (OR 23.3, 95% CI 2.6 - 230.1, P= 0.007), hypocalcaemia (OR 3.8, 95 % CI 1.0 - 14.8, P = 0.047), hyponatraemia (OR 4.5, 95% CI 0.8 - 23.6, P= 0.042), anaemia (OR 2.1, 95% CI 1.0 - 4.3, P= 0.048), diabetes mellitus (OR 1.8, 95 % CI 0.9 - 3.6, P = 0.047), elevated HbA1c (OR 1.8, 95 % CI 1.2 - 2.8, P = 0.007) and current smoking (OR 2.8, 95 % CI 0.9 - 8.6, P = 0.049). Conclusion: Our study identified a higher prevalence of progression of CKD in a prospective longitudinal study of black patients with CKD. Progression of CKD was associated with proteinuria, diabetes mellitus, elevated HbA1c, anaemia, hypocalcaemia, hyponatraemia and current smoking. This is a call for nephrologists and clinicians to be vigilant in identifying CKD patients at risk of CKD progression at early stages as this would allow risk stratification to improve kidney disease outcomes.

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Glomerular hyperfiltration

Cited by 101 publications

References 258 publications

Effects of maternal fructose intake on the offspring’s kidneys

Effects of maternal fructose intake on the offspring’s kidneys

Development of a real-time reporting system of the reference interval for gestational serum creatinine and estimated glomerular filtration rate using machine learning

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

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