Renal hyperfiltration defined by high estimated glomerular filtration rate: A risk factor for cardiovascular disease and mortality

Diabetes Obes Metab. 2019 Nov;21(11):2368-2383. doi: 10.1111/dom.13831. Epub 2019 Jul 29.

Abstract

Renal hyperfiltration, defined as an increased glomerular filtration rate above normal values, is associated with early phases of kidney disease in the setting of various conditions such as obesity and diabetes. Although it is recognized that glomerular hyperfiltration, that is, increased filtration per nephron unit (usually studied at low glomerular filtration levels and often referred to as single nephron hyperfiltration), is a risk factor for the progression of chronic kidney disease, the implications of having renal hyperfiltration for cardiovascular disease and mortality risk are incompletely understood. Recent evidence from diverse populations, including healthy individuals and patients with diabetes or established cardiovascular disease, suggests that renal hyperfiltration is associated with a higher risk of cardiovascular disease and all-cause mortality. In this review, we critically summarize the existing studies, discuss possible mechanisms, and describe the remaining gaps in our knowledge regarding the association of renal hyperfiltration with cardiovascular disease and mortality risk.

Keywords: cardiovascular disease; cardiovascular mortality; diabetes; glomerular hyperfiltration; renal hyperfiltration.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / mortality
  • Diabetes Complications / epidemiology
  • Diabetes Complications / mortality
  • Diabetes Complications / physiopathology
  • Female
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Kidney Glomerulus / physiopathology
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / epidemiology
  • Renal Insufficiency, Chronic* / mortality
  • Renal Insufficiency, Chronic* / physiopathology
  • Risk Factors
  • Young Adult