Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5383
Title: Is hyperfiltration associated with higher urine albumin-to-creatinine ratio at follow up among Indigenous Australians? The eGFR follow-up study
Authors: Ekinci, Elif I
Barr, Elizabeth L M
Barzi, Federica
Hughes, Jaquelyne T
Lawton, Paul D
Jones, Graham R D
Hoy, Wendy
Cass, Alan
Thomas, Mark
Sinha, Ashim 
Jerums, George
O'Dea, Kerin
MacIsaac, Richard J
Maple-Brown, Louise J
Issue Date: 2019
Source: Ekinci EI, Barr ELM, Barzi F, Hughes JT, Lawton PD, Jones GRD, Hoy W, Cass A, Thomas M, Sinha A, Jerums G, O'Dea K, MacIsaac RJ, Maple-Brown LJ. Is hyperfiltration associated with higher urine albumin-to-creatinine ratio at follow up among Indigenous Australians? The eGFR follow-up study. J Diabetes Complications. 2019 May;33(5):343-349. doi: 10.1016/j.jdiacomp.2019.02.005. Epub 2019 Feb 21. PMID: 30904420.
Journal: Journal of diabetes and its complications
Abstract: Glomerular hyperfiltration is not able to be detected in clinical practice. We assessed whether hyperfiltration is associated with albuminuria progression among Indigenous Australians at high risk of diabetes and kidney disease to determine its role in kidney disease progression. Longitudinal observational study of Indigenous Australians aged ≥18 years recruited from >20 sites, across diabetes and/or kidney function strata. At baseline, iohexol clearance was used to measure glomerular filtration rate (mGFR) and hyperfiltration was defined as (i) a mGFR of ≥125 mL/min/1.73 m2, and (ii) an age-adjusted definition, with the top 10% of the mGFR for each 10 year age group at baseline. Baseline and follow-up urine albumin-to-creatinine ratio (uACR) was collected, and linear regression was used to assess the associations of hyperfiltration and uACR at follow up. 407 individuals (33% men, mean age 47 years) were followed-up for a median of 3 years. At baseline, 234 had normoalbuminuria and 173 had albuminuria. Among participants with normoalbuminuria, those with mGFR ≥125 mL/min/1.73 m2 had 32% higher uACR at follow-up (p = 0.08), and those with age-adjusted hyperfiltration had 60% higher uACR (p = 0.037) compared to those who had normofiltration. These associations were independent of uACR at baseline, but attenuated by HbA1c. Associations were stronger among those without than those with albuminuria at baseline. Although not available for assessment in current clinical practice, hyperfiltration may represent a marker of subsequent albuminuria progression among individuals who have not yet developed albuminuria.
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Ashim Sinha
DOI: 10.1016/j.jdiacomp.2019.02.005
Keywords: Albuminuria;Chronic kidney disease;Diabetic kidney disease;Diabetic nephropathy;Hyperfiltration;Indigenous Australians
Type: Article
Appears in Sites:Cairns & Hinterland HHS Publications

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