Prevalence and risk factors of glomerular hyperfiltration in adults with type 2 diabetes: A population‐based study

The impact of abnormal Glomerular Filtration Rate (eGFR) on various adverse outcomes has been well studied; however, the United Arab Emirates (UAE), like many other regions in the world, remains understudied in this area.MethodThis retrospective cohort study estimates the age and sex-specific Glomerular Filtration Rate (eGFR) in the Abu Dhabi population and its association with mortality and Atherosclerotic cardiovascular (ASCVD) outcomes. The cohort of 8699 participants in a national cardiovascular disease screening from 2011 to 2013. The cohort was reevaluated in 2023 for mortality and cardiovascular outcomes. Reference eGFR percentiles were estimated from subjects without comorbidities using the LMS method.ResultsThe reference percentiles of normal eGFR values showed a marked decrease with age, with small sex differences in the reference percentile distribution. A prognostic definition of renal hyperfiltration (RH) is suggested by the observation that subjects in the 97th percentile had a significantly higher incidence of ASCVD, although not statistically significant, in terms of mortality rate.Older age, female sex, history of ASCVD, history of hypertension, being treated for hypertension, lower diastolic blood pressure, higher systolic blood pressure, lower HDL, higher HA1C, and higher vitamin D were significantly associated with lower eGFR percentiles. Subjects in the two categories within the RH range, the 95th and 97th percentiles, had a significantly higher prevalence of diabetes; they are older smokers with higher BMI, higher HA1C, higher HDL, lower vitamin D, and more likely to be males, with higher physical activity and have a lower prevalence of CHD.ConclusionThe distribution of eGFR by age and sex is valuable for clinical decision-making in Abu Dhabi and likely for the Arab population in general. Although the 95th percentile of eGFR in this cohort showed a higher but nonsignificant risk, the 97th percentile is significantly associated with ASCVD, even more than subjects in the less than 10th eGFR percentile. This study provides important insights into the prevalence and risk factors associated with different eGFR percentiles in the Abu Dhabi population. The findings underscore the need for targeted interventions to address modifiable risk factors and prevent the progression of renal damage in this high-risk population.

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Risk Factors of Chronic Kidney Disease Incidence: A Retrospective Cohort Study in Abu Dhabi

AlKetbi,

Hemaid,

AlMansoori

et al. 2024

Preprint

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Background: Chronic kidney disease (CKD) is a growing global health concern, particularly in populations with a high prevalence of cardiovascular risk factors, such as the United Arab Emirates (UAE). Objective: To quantify the burden of CKD among UAE nationals and identify the risk factors that contribute to its development and progression. Methods: This is a retrospective cohort study. In 2023, data was collected from a cohort of 8699 subjects who participated in thenational cardiovascular screening from 2011 to 2013. The follow-up period was an average of 9.2 years. Data was collected from electronic medical records of Emirati adults attending Abu Dhabi primary health centers. Results: At baseline, the study included 8671 participants, with a total CKD prevalence in 2023 of 8%, 6% among females and 10.1% among males. The incidence of CKD over the years of follow up was 7.3%, 5.5% among females and 9.2% among males. Using Cox regression, significant predictors assessed at screening were age, smoking, higher levels of HBA1C, coronary heart disease diagnosis at baseline, hypertension, higher mean blood pressure value, low eGFR, higher levels of vitamin D and eGFR >120 mL/min/1.73m2. The derived predictive model from Cox regression had c-statistics of 0.829, which was better than eGFR alone, which had a c-statistics of 0.803, by 0.026. From bassline subjects’ characteristics, significant associations with greater eGFR decline over the follow-up period were older age higher at baseline, being treated for hypertension, and higher levels of eGFR, HDL, SBP, and HBA1C. Significant associations of baseline characteristics with abnormal Albumin-Creatinine Ratio (ACR) were older age higher at baseline, higher levels of mean blood pressure, lower HDL levels, female sex, and higher eGFR. Having a diagnosis of ASCVD was protective from developing abnormal ACR. Additionally, logistic regression showed significant comorbidities with new onset CKD during the follow-up period, which were older age at screening, acute coronary syndrome, hypertension, metabolic fatty liver disease, and continuing smoking since baseline. In regard to hyperfiltration, defined as eGFR >120 ml/min/1.73m2, its prevalence was 33.5% (28.1% of males and 39.2% of females) at baseline. Significant associations with hyperfiltration were female sex, younger age group, obesity, current smoking, lower systolic blood pressure values, lower cholesterol and vitamin D levels, and higher HDL and HbA1c levels. Conclusion: These findings alert for targeted preventive strategies and comprehensive healthcare interventions to address CKD and its complications in Abu Dhabi. Derived prediction models provide opportunities for targeting these risk factors in clinical practice and stimulate further research opportunities to predict CKD progression.

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Prevalence and risk factors of glomerular hyperfiltration in adults with type 2 diabetes: A population‐based study

Cited by 3 publications

References 27 publications

Serum biochemical evaluation following administration of imidazolyl thiazolidinedione in streptozotocin-induced diabetic rats

Serum biochemical evaluation following administration of imidazolyl thiazolidinedione in streptozotocin-induced diabetic rats

Estimation of age and sex specific Glomerular Filtration Rate in the Abu Dhabi population and its association with mortality and Atherosclerotic cardiovascular outcome. A Retrospective Cohort Study

Risk Factors of Chronic Kidney Disease Incidence: A Retrospective Cohort Study in Abu Dhabi

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