Renal hyperfiltration as a risk factor for chronic kidney disease: A health checkup cohort study

• Published in: PloS one Vol. 15; no. 9; p. e0238177
• Main Authors: Oh, Se Won, Yang, Ji Hyun, Kim, Myung-Gyu, Cho, Won Yong, Jo, Sang Kyung
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 03-09-2020; Public Library of Science (PLoS)
• Subjects: Age; Biology and Life Sciences; Blood pressure; Cardiovascular disease; Cohort analysis; Creatinine; Diabetes; Epidermal growth factor receptors; Glomerular filtration rate; Health risks; Hospitals; Hyperfiltration; Hypertension; Identification methods; Internal medicine; Kidney diseases; Kidneys; Medical schools; Medicine; Medicine and Health Sciences; Monocytes; Nephrology; Proteinuria; Risk analysis; Risk factors; Supervision; Urinalysis; United States > US; South Korea; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0238177

Introduction Renal hyperfiltration (RHF) has been found to be an independent predictor of adverse cardiovascular outcome. However, it remains uncertain whether it is precursor of chronic kidney disease (CKD) in a healthy population. Materials and methods To determine relative risks and identify the predictor of incident proteinuria and decline of estimated glomerular filtration rate (eGFR) in subjects with RHF. A total of 55,992 subjects aged ≥20 years who underwent health check-up during 2004–2017 were included. Among them, 16,946 subjects who completed at least two health checkups were analyzed. Results A total of 949 (5.6%) subjects developed proteinuria and 98 (0.6%) subjects showed ≥ 30% of eGFR decline. The risk of incident proteinuria was significantly higher in those with RHF (RR: 1.644; 95% CI: 1.064–2.541). Those with RHF showed 8.720 fold (95% CI: 4.205–18.081) increased risk for ≥30% decline. ESR, CRP, and monocyte count showed reversed J shaped curve according to the increase of eGFR. The adjusted mean of monocyte count was significantly higher in participants with eGFR ≥90ml/min/1.73m2 or < 60ml/min/1.73m2 compared to that in patients with eGFR 75-89ml/min/1.73m2. Compared to subjects with the lowest tertile of monocyte and no RHF, those with the highest tertile of monocyte count in the RHF group had 3.314-fold (95% CI: 1.893–5.802) higher risk of incident proteinuria and 3.822-fold (95% CI, 1.327–11.006) risk of 30% eGFR decline. Conclusions RHF had significantly increased risk of developing proteinuria and CKD in healthy subjects. Higher monocyte count might be used as a predictor of CKD in subjects with RHF.