Glomerular hyperfiltration is a predictor of adverse cardiovascular outcomes

Area of Science:

• Nephrology
• Cardiology
• Epidemiology

Background:

• The link between glomerular hyperfiltration and cardiovascular events remains unclear.
• Hypertension is prevalent in individuals with varying estimated glomerular filtration rates (eGFR).

Purpose of the Study:

• To determine if glomerular hyperfiltration is an independent predictor of adverse cardiovascular outcomes.
• To investigate the relationship between different levels of eGFR and cardiovascular event risk.

Main Methods:

• Analysis of 8794 participants from 8 prospective studies, with 89% having hypertension.
• Categorization into low, normal, and high eGFR groups based on CKD-EPI calculated eGFR percentiles.
• Multivariable Cox regression models were used to assess cardiovascular event risk, adjusting for multiple covariates.

Main Results:

• Both high and low eGFR groups exhibited significantly higher crude cardiovascular event rates compared to the normal eGFR group.
• In multivariable analysis, high eGFR (HR 1.5) and low eGFR (HR 2.0) were independently associated with increased cardiovascular event risk.
• A U-shaped relationship between eGFR and adverse cardiovascular outcomes was observed.

Conclusions:

• Glomerular hyperfiltration (high eGFR) is a significant and independent predictor of cardiovascular events.
• Kidney function, assessed by eGFR, demonstrates a U-shaped association with cardiovascular risk in a predominantly hypertensive population.