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dc.contributor.authorMelsom, Toralf
dc.contributor.authorNair, Viji
dc.contributor.authorSchei, Jørgen
dc.contributor.authorMariani, Laura
dc.contributor.authorStefansson, Vidar Tor Nyborg
dc.contributor.authorHarder, Jennifer L.
dc.contributor.authorJenssen, Trond Geir
dc.contributor.authorSolbu, Marit Dahl
dc.contributor.authorNorvik, Jon Viljar
dc.contributor.authorLooker, Helen
dc.contributor.authorKnowler, William C.
dc.contributor.authorKretzler, Matthias
dc.contributor.authorNelson, Robert G.
dc.contributor.authorEriksen, Bjørn Odvar
dc.date.accessioned2020-02-06T12:07:00Z
dc.date.available2020-02-06T12:07:00Z
dc.date.issued2019-01-28
dc.description.abstract<p><i>Rationale & Objective - </i>An elevated glomerular filtration rate (GFR), or renal hyperfiltration, may predispose individuals to subsequent rapid GFR decline in diabetes, obesity, and metabolic syndrome. Although this hypothesis is supported by results of experimental studies, the importance of hyperfiltration at the population level remains controversial. We investigated whether higher baseline GFR predicts a steeper decline in GFR. <p><i>Study Design - </i>Longitudinal cohort studies. <p><i>Setting & Participants - </i>1,594 middle-aged Norwegians without diabetes (the Renal Iohexol Clearance Survey [RENIS]) and 319 Pima Indians (83% with type 2 diabetes). <p><i>Predictor - </i>Baseline measured GFR using exogenous clearance methods. <p><i>Outcomes - </i>Change in measured GFR over time. <p><i>Analytical Approach - </i>Linear mixed regression models fit to assess the correlation between the random intercept (reflecting baseline GFR) and random slope (change in GFR over time). <p><i>Results - </i>Mean baseline GFRs were 104.0 ± 20.1 (SD) and 149.4 ± 43.3 mL/min, and median follow-up durations were 5.6 (IQR, 5.2-6.0) and 9.1 (IQR, 4.0-15.0) years in the RENIS and Pima cohorts, respectively. Correlation between baseline GFR (random intercept) and slope of GFR decline was −0.31 (95% CI, −0.40 to −0.23) in the RENIS cohort and −0.41 (95% CI, −0.55 to −0.26) in the Pima cohort, adjusted for age, sex, height, and weight, suggesting that higher baseline GFRs were associated with steeper GFR decline rates. <p><i>Limitations - </i>Different methods for measuring GFR in the 2 cohorts. Renal hyperfiltration may not reflect higher single-nephron GFR. GFR decline is assumed to be linear, which may not match the actual pattern; observed correlations may arise from natural variation. <p><i>Conclusions - </i>Higher baseline GFR is associated with faster decline in GFR over time. If this relationship were causal, elevated GFR would represent a potentially modifiable risk factor for medium- to long-term GFR decline.en_US
dc.identifier.citationMelsom T, Nair, Schei J, Mariani, Stefansson VTN, Harder, Jenssen TG, Solbu MD, Norvik JV, Looker, Knowler, Kretzler M, Nelson RG, Eriksen BO. Correlation between baseline GFR and subsequent change in GFR in Norwegian adults without diabetes and in Pima Indians. American Journal of Kidney Diseases. 2019;76(6):777-785en_US
dc.identifier.cristinIDFRIDAID 1692754
dc.identifier.doi10.1053/j.ajkd.2018.11.011
dc.identifier.issn0272-6386
dc.identifier.issn1523-6838
dc.identifier.urihttps://hdl.handle.net/10037/17340
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalAmerican Journal of Kidney Diseases
dc.rights.accessRightsopenAccessen_US
dc.rights.holder©2019 by the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Nephrology, urology: 772en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nefrologi, urologi: 772en_US
dc.titleCorrelation between baseline GFR and subsequent change in GFR in Norwegian adults without diabetes and in Pima Indiansen_US
dc.type.versionacceptedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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