Is hyperfiltration associated with the future risk of developing diabetic nephropathy? A meta-analysis
| Autor: | Frank Kee, Damian Fogarty, G. M. Magee, Rudy Bilous, Steven J. Hunter, Christopher Cardwell |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Kidney Glomerulus Renal function Diabetic nephropathy Nephropathy Young Adult Risk Factors Internal medicine Chronic Kidney Disease Internal Medicine medicine Albuminuria Humans Glomerular Diabetic Nephropathies Age of Onset Risk factor Progression business.industry Patient Selection Diabetes Hemodynamics medicine.disease Surgery Meta-analysis Diabetes Mellitus Type 1 Disease Progression Microalbuminuria medicine.symptom business Glomerular hyperfiltration Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Magee, G M, Bilous, R W, Cardwell, C, Hunter, S J, Kee, F & Fogarty, D 2009, ' Is hyperfiltration associated with the future risk of developing diabetic nephropathy? A meta-analysis. ', Diabetologia, vol. 52, no. 4, pp. 691-697 . https://doi.org/10.1007/s00125-009-1268-0 |
| ISSN: | 1432-0428 0012-186X |
| DOI: | 10.1007/s00125-009-1268-0 |
| Popis: | Aims/hypothesis Glomerular hyperfiltration is a well established phenomenon occurring early in some patients with type 1 diabetes. However, there is no consistent answer regarding whether hyperfiltration predicts later development of nephropathy. We performed a systematic review and meta-analysis of observational studies that compared the risk of developing diabetic nephropathy in patients with and without glomerular hyperfiltration and also explored the impact of baseline GFR.Methods A systematic review and meta-analysis was carried out. Cohort studies in type 1 diabetic participants were included if they contained data on the development of incipient or overt nephropathy with baseline measurementof GFR and presence or absence of hyperfiltration. Results We included ten cohort studies following 780 patients. After a study median follow-up of 11.2 years, 130 patients had developed nephropathy. Using a random effects model, the pooled odds of progression to a minimumof microalbuminuria in patients with hyperfiltration was 2.71 (95% CI 1.20–6.11) times that of patients with normofiltration. There was moderate heterogeneity (heterogeneity test p=0.05, measure of degree of inconsistency=48%) and some evidence of funnel plot asymmetry, possibly due to publication bias. The pooled weighted mean difference in baseline GFR was 13.8 ml min-1 1.73 m-2 (95% CI 5.0–22.7) greater in the group progressing to nephropathy than in those not progressing (heterogeneity test pConclusions/interpretation In published studies, individuals with glomerular hyperfiltration were at increased risk of progression to diabetic nephropathy using study level data. Further larger studies are required to explore this relationship and the role of potential confounding variables. |
| Databáze: | OpenAIRE |
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