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Kidney Week

Abstract: PO2498

Association of Metabolic Syndrome with Hyperfiltration in a General Non-Diabetic Population: The Renal Iohexol Clearance Survey

Session Information

Category: CKD (Non-Dialysis)

  • 2103 CKD (Non-Dialysis): Mechanisms

Authors

  • Bystad, Erikka Wikan, UiT Norges arktiske universitet, Tromso, Troms, Norway
  • Melsom, Toralf, UiT Norges arktiske universitet, Tromso, Troms, Norway
Background

Metabolic syndrome (MS) affects approximately one quarter of the world, making it a global epidemic. Although MS has been associated with increased risk of rapid decline in the glomerular filtration rate (GFR), only a few studies have investigated the association of MS with abnormally elevated GFR, known as hyperfiltration. Previous studies of MS and hyperfiltration were limited by the use of estimated GFR and the results were divergent. As there are promising treatment options for hyperfiltration, establishing the relationship between MS and hyperfiltration is of clinical importance.

Methods

In the Renal Iohexol Clearence Survey (RENIS) we included 1551 subjects from the population based Tromsø survey (2007-2009). The participants were 50-62 years old without known diabetes, cardiovascular disease or kidney disease. The GFR was measured using iohexol clearance. The aim was to investigate the relationship between MS and RHF. The dichotomous variable for RHF was defined as an absolute mGFR (ml/min) above the 90th percentile after adjusting for gender, age and height.

Results

Metabolic syndrome was associated with increased absolute GFR (ml/min) and renal hyperfiltration (yes/no) independent of age, sex and height (OR 2.44 95% CI; 1.71 – 3.46, p<0.001). All risk factors except for hypertension were independently associated with RHF and increased absolute GFR. The risk of renal hyperfiltration was highest in subjects fulfilling 5 out of 5 criteria (OR 4.06, 95% CI; 1.54-10.67, p=0.005) compared to those fulfilling 0 or 1 criteria. Conversely, MS was not associated with higher estimated GFR based on creatinine or cystatin C.

Conclusion

Subjects with MS have a higher absolute GFR and increased risk of renal hyperfiltration compared to subjects without MS. RCTs are needed to explore whether treatment of hyperfiltration can prevent accelerated GFR decline and CKD in persons with MS.