Highlights
- •Although glomerular hyperfiltration (GHF) was associated with metabolic risk and CVD, its role has been underrated because definition was not unified.
- •GHF with adjustment for confounding factors was associated with the presence of significant carotid plaque (plaque score ≥2).
- •Carotid plaque is associated with the risk of cardiovascular disease (CVD). GHF can be a useful surrogate for surveillance of CVD.
Abstract
Background and aims
Glomerular hyperfiltration (GHF) is a hemodynamic change of the kidney as an adaptive
response to nephron loss. Although GHF is associated with metabolic risk factors and
cardiovascular disease (CVD), the mechanisms that explain these relationships remain
largely unknown. This is partially caused by a non-unified definition of GHF based
on pathophysiologic vascular changes. Thus, the objective of this study was to evaluate
the association between various definitions of GHF and carotid plaque in a health
checkup cohort.
Methods
A total of 4493 individuals without history of CVD who had carotid ultrasonography
(USG) results available between January 2016 and June 2018 were enrolled. GHF was
defined as >90th percentile of eGFR residuals after adjusting for confounding factors.
Carotid plaque score was calculated based on carotid USG results.
Results
Of 4493 individuals (mean age, 52.3 ± 10.1 years; 3224 [71.8%] males), 449 subjects
were included in the GHF group (mean eGFR, 107.0 ± 7.1 ml/min/1.73 m2) and 4044 subjects were included in the non-GHF group (mean eGFR, 92.5 ± 12.3 ml/min/1.73 m2). When the GHF group was compared to the non-GHF group, GHF was associated with the
presence of significant carotid plaque (carotid plaque score ≥2) (adjusted OR: 1.46;
95% CI: 1.16 to 1.83; p = 0.001). GHF defined in this study showed higher sensitivity to the presence of
carotid plaque than other definitions of GHF.
Conclusions
GHF status was associated with risk of carotid plaque in individuals without history
of CVD. Presence of subclinical carotid plaque was associated with risk of future
CVD. Therefore, GHF based on creatinine could be a useful surrogate marker for surveillance
of CVD in asymptomatic individuals.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
GHF (glomerular hyperfiltration), CVD (cardiovascular disease)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 24, 2023
Accepted:
January 18,
2023
Received in revised form:
December 30,
2022
Received:
September 6,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier B.V. All rights reserved.
