Unmasking the hidden burden of prediabetes on kidney function

Melsom et al. provide compelling evidence that prediabetes is associated with accelerated decline in kidney function when measured by measured glomerular filtration rate using iohexol clearance, a relationship not detected using estimated glomerular filtration rate equations. These findings challenge current screening practices and suggest that the burden of kidney disease in individuals with prediabetes may be underestimated. The study underscores the need for more accurate kidney function assessments and earlier intervention in at-risk populations.