title: Renal hyperfiltration as a novel marker of all-cause mortality.
abstract: Although renal hyperfiltration (RHF) or an abnormal increase in GFR has been associated with many lifestyles and clinical conditions, including diabetes, its clinical consequence is not clear. RHF is frequently considered to be the result of overestimating true GFR in subjects with muscle wasting. To evaluate the association between RHF and mortality, 43,503 adult Koreans who underwent voluntary health screening at Seoul National University Hospital between March of 1995 and May of 2006 with baseline GFR≥60 ml/min per 1.73 m(2) were followed up for mortality until December 31, 2012. GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and RHF was defined as GFR>95th percentile after adjustment for age, sex, muscle mass, and history of diabetes and/or hypertension medication. Muscle mass was measured with bioimpedance analysis at baseline. During the median follow-up of 12.4 years, 1743 deaths occurred. The odds ratio of RHF in participants with the highest quartile of muscle mass was 1.31 (95% confidence interval [95% CI], 1.11 to 1.54) compared with the lowest quartile after adjusting for confounding factors, including body mass index. The hazard ratio of all-cause mortality for RHF was 1.37 (95% CI, 1.11 to 1.70) by Cox proportional hazards model with adjustment for known risk factors, including smoking. These data suggest RHF may be associated with increased all-cause mortality in an apparently healthy population. The possibility of RHF as a novel marker of all-cause mortality should be confirmed.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea;
authors.forename: Minseon
authors.initials: M
authors.lastname: Park
authors.affiliation: Interdisciplinary Program for Bioengineering, Seoul National University College of Engineering, Seoul, South Korea;
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yoon
authors.affiliation: Interdisciplinary Program for Bioengineering, Seoul National University College of Engineering, Seoul, South Korea; Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, South Korea; and.
authors.forename: Youn-Hee
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Interdisciplinary Program for Bioengineering, Seoul National University College of Engineering, Seoul, South Korea; Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, South Korea; and.
authors.forename: Ho
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Jinwook
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea hjyoon@snu.ac.kr.
authors.forename: Hyung-Jin
authors.initials: HJ
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007678:Kidney Glomerulus / Q000378:metabolism / Q000503:physiopathology*; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000401:mortality* / Q000503:physiopathology; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis
keywords: CKD; GFR; epidemiology and outcomes; glomerular hyperfiltration; mortality