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The impact of hyperfiltration on the diabetic kidney

Premaratne, Erosha, Verma, S., Ekinci, Elif, Theverkalam, G., Jerums, George and MacIsaac, Richard J. (2015). The impact of hyperfiltration on the diabetic kidney. Diabetes & Metabolism,41(1):5-17.

Document type: Journal Article
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IRMA ID 11381xPUB50
Title The impact of hyperfiltration on the diabetic kidney
Author Premaratne, Erosha
Verma, S.
Ekinci, Elif
Theverkalam, G.
Jerums, George
MacIsaac, Richard J.
Journal Name Diabetes & Metabolism
Publication Date 2015
Volume Number 41
Issue Number 1
ISSN 1262-3636   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84921772366
Start Page 5
End Page 17
Total Pages 13
Place of Publication France
Publisher Elsevier Masson
HERDC Category C1 - Journal Article (DIISR)
Abstract More than two decades ago, hyperfiltration (HF) in diabetes was postulated to be a maladaptive response observed early in the course of diabetic kidney disease (DKD), which may eventually predispose to irreversible damage to nephrons and development of progressive renal disease. Despite this, the potential mechanisms leading to renal HF in diabetes are not fully understood, although several hypotheses have been proposed, including alterations in glomerular haemodynamic function and tubulo-glomerular feedback. Furthermore, the role of HF as a causative factor in renal disease progression is still unclear and warrants further prospective longer-term studies. Although HF has been entrenched as the first stage in the classic albuminuric pathway to end-stage renal disease in DKD, and HF has been shown to predict the progression of albuminuria in many, but not all studies, the concept that HF predisposes to the development of chronic kidney disease (CKD) stage 3, that is, glomerular filtration rate (GFR) decline to < 60 mL/min/1.73m2, remains to be proved. Further long-term studies of GFR gradients therefore are required to establish whether HF ultimately leads to decreased kidney function, after adjustment for glycaemic control and other confounders. Whether reversal of HF with therapeutic agents is protective against reducing the risk of development of albuminuria and renal impairment is also worth investigating in prospective randomized trials.
Keywords Hyperfiltration
Diabetic kidney disease
Metabolic syndrome
Vascular disease
Diabetic nephropathy
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Created: Tue, 26 Jul 2016, 12:33:25 CST