Thresholds and prevalence of glomerular hyperfiltration across blood pressure categories in low-risk european population

Objective: Aims of this study were to define thresholds for GH in a healthy low-risk European population using an age and gender-specific 95th percentile cut-offs, and to determine the prevalence of GH based on various eGFR equations across blood pressure (BP) categories. Design and method: In cross-sectional survey we included 1105 apparently healthy untreated participants from general population. There were 294, 412, and 400 normotensive, prehypertensive, and untreated hypertensive participants, respectively. The eGFR was calculated using CKD Epi equations, absolute GFR equation, MDRD and Cockcroft-Gault equations. Subjects were divided into the age quintiles. Prevalence of GF was determined for each equation and differences among BP categories were calculated. Results: Highest prevalence was found when GFR was estimated with CKD EPI equations. The lowest prevalence was observed with absolute GFR and Cockcroft-Gault equations (Figure 1). We failed to find differences in the prevalence of GH among the BP categories with the CKD EPI equations. Significant positive trend in the prevalence of GH from subjects with normal BP to the subjects with untreated hypertension was found when we used absolute GFR and Cockcroft-Gault equations. Subjects with GH had more obesity, dyslipidaemia, inflammation and salt intake compared to subjects with normal eGFR. In multinominal logistic regression, among subjects with eGFR >60 ml/min/1.73 m2, PP > 60 mmHg, ACR and salt intake increases the risk for GH by 96.4%, 90% and 83.9%, respectively. In the group of subjects with eGFR < 60 ml/min/1.73 m2, PP > 60 mmHg, ACR and being obese vs. having normal BMI increases the risk for GH by 94.4%, 88.8% and 10.2%, respectively. Obesity, ACR, PP and salt intake are risk factors for GH in apparently healthy Caucasians. Conclusions: There is no unique threshold value for GH, and age-gender - 95th cut off values should be used. CKD-Epi equations overestimate the prevalence of GH compared to de-indexed and Cockcroft-Gault equations. Differences in GH prevalence among BP categories were observed only without indexation for 1.73.