Different association between renal hyperfiltration and mortality by sex.

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Epidemiology

Background:

• Renal hyperfiltration (RHF) signifies early kidney injury and is a newly identified mortality marker.
• A clear, standardized definition for RHF is currently lacking.
• Understanding RHF's association with mortality, particularly by sex, is crucial for clinical practice.

Purpose of the Study:

• To propose an age- and sex-adjusted definition for RHF.
• To investigate the relationship between RHF and all-cause mortality, stratified by sex.

Main Methods:

• Analysis of health examination data from 114,966 individuals (1995-2009).
• RHF defined as estimated glomerular filtration rate (eGFR) above the 95th percentile, adjusted for age and sex.
• Survival analysis, including Kaplan-Meier curves and multivariate analysis, performed separately for men and women.

Main Results:

• RHF was associated with higher mortality in both sexes, but significantly more pronounced in men.
• In men, RHF was an independent risk factor for all-cause mortality (HR, 1.34; 95% CI, 1.12-1.59).
• No significant association between RHF and mortality was observed in women.

Conclusions:

• RHF is a significant predictor of mortality in men, but not in women.
• The distinct sex-based associations warrant further investigation into underlying mechanisms and clinical relevance.