Hyperfiltration in African-American patients with type 2 diabetes. Cross-sectional and longitudinal data.
OBJECTIVE
Hyperfiltration may play a role in the development of diabetic nephropathy. African-American patients with diabetes have more than a fourfold increase in end-stage renal disease. The purpose of this study is to evaluate the impact of hyperfiltration on renal function in African-American patients with type 2 diabetes.


METHODS
Renal function of 194 African-American patients with diagnosed type 2 diabetes from 1 month to 36 years was assessed by studies of isotopic glomerular filtration rate (GFR), serum creatinine, creatinine clearance, and 24-h urinary albumin excretion rates. Thirty-four patients with a duration of diagnosed type 2 diabetes from 1 month to 10 years were found to have hyperfiltration (GFR > or = 140 ml.min-1.1.73 m-2). Fifteen of these patients received longitudinal follow-up of renal function for as long as 15 years after the initial study.


RESULTS
Hyperfiltration is present in 15 (36%) of 42 patients whose duration of diagnosed type 2 diabetes is < 1 year, and it persists for up to 10 years in 14-20% of patients with diagnosed type 2 diabetes. Patients with hyperfiltration are younger than their counterparts without hyperfiltration when matched for duration of diagnosed diabetes. When followed over time, those patients with hyperfiltration were not more likely to develop impaired renal function as measured by GFR or creatinine clearance.


CONCLUSIONS
Hyperfiltration does not identify patients at risk for deterioration in renal function.
Chaiken
R L
RL
Division of Endocrinology and Metabolism, State University of New York-Health Science Center at Brooklyn 11203, USA.
Eckert-Norton
M
M
Bard
M
M
Banerji
M A
MA
Palmisano
J
J
Sachimechi
I
I
Lebovitz
H E
HE
D000328:Adult; D001741:Black or African American; D000419:Albuminuria; D044383:Black People; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000503:physiopathology*; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007457:Iodine Radioisotopes; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology; D008137:Longitudinal Studies; D008875:Middle Aged; D009519:New York City; D011507:Proteinuria; D012039:Regional Blood Flow; D012079:Renal Circulation; D012307:Risk Factors; D013997:Time Factors
D003404:Creatinine; D006442:Glycated Hemoglobin; D007457:Iodine Radioisotopes