Related Experiment Video
Updated: Apr 18, 2026
A High-throughput Method for Measurement of Glomerular Filtration Rate in Conscious Mice
Published on: May 10, 2013
A systematic review of glomerular hyperfiltration assessment and definition in the medical literature
Francois Cachat1, Christophe Combescure2, Michel Cauderay3
1Department of Pediatrics, Division of Pediatric Nephrology, University Hospital, Lausanne, Switzerland; francois.cachat@chuv.ch.
Insights
Defining glomerular hyperfiltration (GH) varies widely, hindering research comparisons. This study reveals inconsistent methods for GH threshold determination, emphasizing the need for standardized definitions in clinical trials.
Area of Science:
- Nephrology
- Renal Physiology
- Clinical Research Methodology
Background:
- Glomerular hyperfiltration (GH) evaluation is challenging due to inconsistent definitions across studies.
- Lack of a universal GH definition impedes comparisons of clinical trial results aimed at its reduction.
Purpose of the Study:
- To systematically assess the methodologies and definitions of GH used in scientific literature.
- To identify variations in GH threshold determination and their implications for research.
Main Methods:
- A systematic literature search was conducted across Embase, MEDLINE, and CINAHL databases.
- Studies reporting GH thresholds or analyzing high glomerular filtration rate (GFR) continuously were included.
- Data on threshold usage, justification, and demographic considerations were extracted.
Main Results:
- Over half of the studies (55.6%) reported a GH threshold, with most using a single value.
- A significant portion of studies (29.8%) lacked clear justification or control groups for threshold selection.
- The use of GH thresholds increased post-2004, while the use of control groups for definition decreased.
Conclusions:
- A substantial percentage of studies (30%) failed to adequately justify their chosen GH threshold values.
- Age-related GFR decline in the elderly was infrequently considered when defining GH.
- Standardized methodology, including age- and sex-matched control groups, is recommended for defining GH thresholds.
Background And Objectives:
Evaluation of glomerular hyperfiltration (GH) is difficult; the variable reported definitions impede comparisons between studies. A clear and universal definition of GH would help in comparing results of trials aimed at reducing GH. This study assessed how GH is measured and defined in the literature.
Design, Setting, Participants, & Measurements:
Three databases (Embase, MEDLINE, CINAHL) were systematically searched using the terms "hyperfiltration" or "glomerular hyperfiltration". All studies reporting a GH threshold or studying the effect of a high GFR in a continuous manner against another outcome of interest were included.
Results:
The literature search was performed from November 2012 to February 2013 and updated in August 2014. From 2013 retrieved studies, 405 studies were included. Threshold use to define GH was reported in 55.6% of studies. Of these, 88.4% used a single threshold and 11.6% used numerous thresholds adapted to participant sex or age. In 29.8% of the studies, the choice of a GH threshold was not based on a control group or literature references. After 2004, the use of GH threshold use increased (P<0.001), but the use of a control group to precisely define that GH threshold decreased significantly (P<0.001); the threshold did not differ among pediatric, adult, or mixed-age studies. The GH threshold ranged from 90.7 to 175 ml/min per 1.73 m(2) (median, 135 ml/min per 1.73 m(2)).
Conclusion:
Thirty percent of studies did not justify the choice of threshold values. The decrease of GFR in the elderly was rarely considered in defining GH. From a methodologic point of view, an age- and sex-matched control group should be used to define a GH threshold.
