Related Experiment Video
Updated: Aug 5, 2026

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
Published on: May 2, 2025
Glomerular hyperfiltration in dipstick-negative type 2 diabetes mellitus: a novel determinant of kidney function
Dughyun Choi1, Samel Park2, Dong-Sub Kim2
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
Background:
The independent impact of type 2 diabetes mellitus (T2DM) on kidney outcomes beyond albuminuria remains unclear. We evaluated whether T2DM affects kidney outcomes in individuals with normal kidney function without albuminuria.
Methods:
Data from the National Health Insurance Service-National Sample Cohort of Korea (2009-2015) were analyzed. Individuals with normal kidney function were stratified by T2DM status. The primary outcome was a composite kidney outcome consisting of initiation of kidney replacement therapy and a sustained decline in estimated glomerular filtration rate (eGFR) of ≥40% from baseline.
Results:
Among 77,267 individuals with normal kidney function without albuminuria, patients with T2DM (n = 11,957) showed significantly steeper annual decline in eGFR than non-T2DM individuals (-0.113 mL/min per 1.73 m2 per year; 95% confidence interval [CI], -0.222 to -0.003). T2DM was associated with a 57% higher risk of composite kidney outcome (adjusted hazard ratio, 1.57; 95% CI, 1.28-1.92), independent of traditional risk factors. This association was strongest in individuals with glomerular hyperfiltration and longer T2DM duration (≥6 years).
Conclusion:
Normal kidney function T2DM was associated with accelerated kidney function decline and a 1.5-fold increased risk of adverse kidney outcomes compared with normal kidney function non-T2DM, particularly in individuals with glomerular hyperfiltration and longer duration.
Related Concept Videos
Diabetic Nephropathy
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Hyperglycemia
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
Type I Diabetes III: Clinical Manifestations
Type II Diabetes II: Pathophysiology
