Significant Difference In eGFR Research Articles

Influence of Cigarette Smoking on Estimated Glomerular Filtration Rate (eGFR) in Japanese Male Workers

The link between changes in estimated glomerular filtration rate (eGFR) and cigarette smoking was evaluated in Japanese male workers with a 5-year follow-up. We examined the data of 456 Japanese male workers, aged 22-70 years, who were taking no medications, and from this group, 286 men (43.5±8.2 years) were followed for 5-years. Habits of cigarette smoking were obtained during interviews by well-trained staff. The influence of cigarette smoking on eGFR was evaluated. In the first analysis, there was no significant difference in eGFR between subjects with and without cigarette smoking. In the second analysis, eGFR was significantly reduced after 5 years in all subjects. Changes in eGFR in subjects with cigarette smoking (-1.90±12.31 ml/min/1.73 m²) were significantly smaller than those in subjects without cigarette smoking (-4.97±12.05 ml/min/1.73 m²). At follow-up, we found that eGFR was weakly and negatively correlated with the number of cigarettes smoked (/day). The present study indicated that cigarette smoking may be an important modifiable factor for eGFR in Japanese male workers who are not taking any medications.

Relationship between Kidney Function and Liver Histology in Subjects with Nonalcoholic Steatohepatitis

We assessed whether nonalcoholic steatohepatitis (NASH) diagnosed by liver biopsy is associated with decreased kidney function and whether such association is independent of insulin resistance and features of the metabolic syndrome. We enrolled 80 consecutive overweight patients with biopsy-proven NASH and 80 nonsteatotic control subjects who were matched for age, gender, and body mass index. Chronic kidney disease (CKD) was defined as the presence of estimated GFR (eGFR) of ≤60 ml/min per 1.73 m(2) and/or abnormal albuminuria (i.e., urinary albumin/creatinine ratio ≥30 mg/g). NASH patients had significantly (P < 0.001) lower eGFR (75.3 ± 12 versus 87.5 ± 6 ml/min per 1.73 m(2)) and a greater frequency of abnormal albuminuria (14 versus 2.5%) and CKD (25 versus 3.7%) than control subjects. The significant differences in eGFR, albuminuria, and CKD that were observed between the two groups were only slightly weakened after adjustment for age, gender, body mass index, smoking status, insulin resistance (by homeostasis model assessment), and components of the metabolic syndrome. Notably, histologic severity of NASH (i.e., fibrosis stage) was strongly associated with either decreasing eGFR or increasing albuminuria (P < 0.01 or less), independently of potential confounding factors. Our findings suggest that patients with biopsy-proven NASH have moderately decreased eGFR and a higher frequency of abnormal albuminuria and CKD than matched control subjects and that the severity of NASH histology is associated with decreased kidney function, independently of traditional risk factors, insulin resistance, and components of the metabolic syndrome.

Pre-emptive liver transplantation for primary hyperoxaluria (PH-I) arrests long-term renal function deterioration

Primary hyperoxaluria-I (PH-I) is a serious metabolic disease resulting in end-stage renal disease. Pre-emptive liver transplantation (PLT) for PH-I is an option for children with early diagnosis. There is still little information on its effect on long-term renal function in this situation. Long-term assessment of renal function was conducted using Schwartz's formula (estimated glomerular filtration rate-eGFR) in four children (Group A) undergoing PLT between 2002 and 2008, and a comparison was done with eight gender- and sex-matched controls (Group B) having liver transplantation for other indications. All patients received a liver graft from a deceased donor. Median follow-up for the two groups was 64 and 94 months, respectively. One child in Group A underwent re-transplantation due to hepatic artery thrombosis, while acute rejection was seen in one. A significant difference was seen in eGFR at transplant (81 vs 148 mL/min/1.73 m(2)) with greater functional impairment seen in the study population. In Group A, renal function reduced by 21 and 11% compared with 37 and 35% in Group B at 12 and 24 months, respectively. At 2 years post-transplantation, there was no significant difference in eGFR between the two groups (72 vs 100 mL/min/1.73 m(2), respectively; P = 0.06). Renal function remains relatively stable following pre-emptive LTx for PH-I. With early diagnosis of PH-I, isolated liver transplantation may prevent progression to end-stage renal disease and the need for renal transplantation.

EGFRandhTERTExpression as a Diagnostic Approach for Non-small Cell Lung Cancer in High Risk Groups

Objective:The early detection of NSCLC is of importance because it provides chances for better outcomes. The aim of the study was to explore the clinical utility of EGFR and hTERT mRNA expression as markers for diagnosis of NSCLC.Methods:EGFR and hTERT mRNA were quantified by quantative reverse transcription real time polymerase chain reaction in plasma of 45 non-small cell lung cancer (NSCLC) and 40 chronic obstructive pulmonary disease (COPD) patients, selected by certain spirometric characteristics that made them at high risk of developing lung cancer in future.Results:The gene expression level of each gene was calculated and given as a relative quantity—RQ. EGFR gene expression was found in all lung cancer patients. The mean level of expression was RQ = 29.39. hTERT mRNA could be detected in 88% of patients. The mean expression ratio in them was RQ = 17.31. Only 50% of the high risk patients turned to be positive for EGFR. The level of their expression was RQ = 2.09. The plasma levels of hTERT could be detected in 17 (42.5%) patients of the high risk COPD group. Their mean level of expression was RQ = 1.02. A statistically significant difference in EGFR and hTERT mRNA expression could be observed between the two groups of patients—p = 0.0001.Conclusion:EGFR and hTERT mRNA are potential markers for lung cancer diagnosis, whose clinical importance should be replicated in a larger cohort of patients.

Evaluation of renal function and proteinuria based on mass health examinations in young Japanese obese adults

Although obesity is recognized to be a risk factor for chronic kidney disease (CKD), few studies have reported the association between obesity and CKD in the young population. We investigated the relationship between obesity and renal function including proteinuria in young Japanese. This cross-sectional study consisted of 16,031 men and 5,746 women aged from 20 to 39 years who received health examinations. The subjects were stratified into four age groups (20-24, 25-29, 30-34, and 35-39 years) or into four groups based on the number of risk factors (hypertension, hyperglycemia, dyslipidemia, and hyperuricemia). The relationship between obesity and risk factors and the relationship between obesity and estimated glomerular filtration rate (eGFR) were analyzed. There were no significant differences in eGFR between obese and nonobese groups, except in the male 35-39 years age group. Body mass index (BMI) in both men and women increased with increase in number of risk factors (P < 0.001). Multivariate analysis revealed that hypertension, hyperglycemia, dyslipidemia, and hyperuricemia were independently associated with obesity. Obesity and the risk factors were independently associated with proteinuria. The present study indicated that obesity was an independent risk factor for proteinuria in healthy subjects younger than 40 years of age. The other risk factors were independently associated with obesity. These findings suggest that obesity causes proteinuria concomitantly with other risk factors such as hypertension, diabetes, and dyslipidemia in young adults.

Effect of Ethnicity on the Progression of Diabetic Kidney Disease Independent of Glycemic Control

Background/Aims: The prevalence of diabetic kidney disease (DKD) and risk of progression to end-stage renal disease is higher in African-Americans as compared to Caucasians. Whether the higher rate of estimated glomerular filtration rate (eGFR) decline in African-Americans is mediated by poor glycemic control is unclear. Methods: We conducted a prospective study of 183 (African-American, n = 95; Caucasian, n = 88, mean age 66 ± 10 vs. 70 ± 11 years) patients with a diagnosis of DKD followed over a period of 12 months. eGFR (ml/min/1.73 m²) was calculated by MDRD formula and grouped into stage 1–2 (≥60 ml/min), stage 3 (30–60 ml/min) and stage 4 (<30 ml/min). In addition, glycosylated hemoglobin A1C (HbA1c) was categorized into tertiles (<7, 7–8 and >8%) at each time point. Results:There were no significant differences in eGFR at any time point between African-American and Caucasian in any stage of CKD during this period. There were also no significant differences in eGFR at any time point in each category of HbA1c. Conclusions: Our data indicate that there were no ethnic differences in the rate of progression of DKD under equivalent glycemic control. Further research is needed to explore the mechanisms associated with higher prevalence and rapid progression of CKD in African-Americans compared to Caucasians.

‘Microalbuminuric anaemia’—The relationship between haemoglobin levels and albuminuria in diabetes

Background There is an increasing incidence of anaemia in diabetes despite the absence of significant renal impairment. Aims This study set out to determine the prevalence of anaemia in a diabetic population and to explore the relationship between anaemia and urinary albumin excretion in diabetes mellitus. Also, to determine the difference between those with overt nephropathy, microalbuminuria and those without evidence of renal disease. Methods Five hundred and two consecutive diabetes patients were screened for anaemia. Anaemia was defined by World Health Organization criteria (<13 g/dl for men and <12 g/dl for women). Urinary albumin excretion was determined by urinary albumin creatinine ratio (ACR) from a single urine sample. Results Anaemia was present in 118 (23.5%) patients. There was a rise in the prevalence of anaemia from 19% in patients with a normal ACR to 29% in those with microalbuminuria and to 41% in macroalbuminuria. This increase in the prevalence of anaemia in microalbuminuria compared to normoalbuminuria was not explained by declining renal function as there was no significant difference in eGFR between the two groups. Conclusion Anaemia was common in the study population. Early detection and correction of anaemia in diabetes is important for patients at risk of impaired quality of life and increased cardiovascular risk.

Is there a relationship between glomerular filtration rate and detrusor overactivity in women?

The relationship of detrusor overactivity (DO) to neuromuscular causes is well established, but a connection to kidney function has not yet been studied. We sought to evaluate whether patients with DO have differences in estimated glomerular filtration rate (eGFR). After Institutional Review Board approval, we collected data from all patients who underwent urodynamic testing in our office from September 1, 2006 to February 28, 2007 and calculated eGFR using the equation derived from the Modification of Diet in Renal Disease (MDRD) study. Data were collected on 359 patients, who had a mean eGFR for all patients of 82.99 ml/min/1.73 m(2) (+/-22.2). The patients were divided into groups by the presence or absence of DO on filling cystometry. There was no significant difference in eGFR between the patients with and without DO (80.9 ml/min/1.73 m(2) vs. 84.4, P = 0.290). Kidney function does not differ between patients with or without DO.