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2015 ; 10
(3
): 382-9
Nephropedia Template TP
gab.com Text
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A systematic review of glomerular hyperfiltration assessment and definition in
the medical literature
#MMPMID25568216
Cachat F
; Combescure C
; Cauderay M
; Girardin E
; Chehade H
Clin J Am Soc Nephrol
2015[Mar]; 10
(3
): 382-9
PMID25568216
show ga
BACKGROUND AND OBJECTIVES: Evaluation of glomerular hyperfiltration (GH) is
difficult; the variable reported definitions impede comparisons between studies.
A clear and universal definition of GH would help in comparing results of trials
aimed at reducing GH. This study assessed how GH is measured and defined in the
literature. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Three databases
(Embase, MEDLINE, CINAHL) were systematically searched using the terms
"hyperfiltration" or "glomerular hyperfiltration". All studies reporting a GH
threshold or studying the effect of a high GFR in a continuous manner against
another outcome of interest were included. RESULTS: The literature search was
performed from November 2012 to February 2013 and updated in August 2014. From
2013 retrieved studies, 405 studies were included. Threshold use to define GH was
reported in 55.6% of studies. Of these, 88.4% used a single threshold and 11.6%
used numerous thresholds adapted to participant sex or age. In 29.8% of the
studies, the choice of a GH threshold was not based on a control group or
literature references. After 2004, the use of GH threshold use increased
(P<0.001), but the use of a control group to precisely define that GH threshold
decreased significantly (P<0.001); the threshold did not differ among pediatric,
adult, or mixed-age studies. The GH threshold ranged from 90.7 to 175 ml/min per
1.73 m(2) (median, 135 ml/min per 1.73 m(2)). CONCLUSION: Thirty percent of
studies did not justify the choice of threshold values. The decrease of GFR in
the elderly was rarely considered in defining GH. From a methodologic point of
view, an age- and sex-matched control group should be used to define a GH
threshold.