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Hyperfiltration in Indigenous Australians with and without diabetes

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 and Maple-Brown, Louise J. (2015). Hyperfiltration in Indigenous Australians with and without diabetes. Nephrology Dialysis Transplantation,30(11):1877-1884.

Document type: Journal Article
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IRMA ID 11381xPUB72
Title Hyperfiltration in Indigenous Australians with and without diabetes
Author 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.
Journal Name Nephrology Dialysis Transplantation
Publication Date 2015
Volume Number 30
Issue Number 11
ISSN 0931-0509   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84948433996
Start Page 1877
End Page 1884
Total Pages 8
Place of Publication United Kingdom
Publisher Oxford University Press
Field of Research 1117 - Public Health and Health Services
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
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.

Methods
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 m2, 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 m2); (ii) age-corrected mGFR (>144 mL/min/1.73 m2) to account for the effect of ageing on GFR in subjects over 40 years of age with cut-off 1 mL/min/1.73 m2 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 m2, without adjustment for age.

Results
A total of 383 Indigenous participants, 125 with and 258 without diabetes, with mGFR > 90 mL/min/1.73 m2 were studied. The proportion of participants with HF was 7% using mGFR > 144 mL/min/1.73 m2, 11% using the age-adjusted definition, 19% using mGFR > 144 mL/min and 27% using mGFR > 125 mL/min/1.73 m2. Diabetes was more common in participants with HF (40–74%) compared with normofiltering participants (28–31%), regardless of the definition of HF.

Conclusions
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
Keywords CKD-EPI equation
diabetic kidney disease
ethnicity
glomerular filtration rate
hyperfiltration
DOI http://dx.doi.org/10.1093/ndt/gfv230   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Tue, 26 Jul 2016, 12:44:33 CST