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Glomerular hyperfiltration: part 1 — defining the threshold — is the sky the limit?

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Abstract

Glomerular hyperfiltration (GHF) is an increase in single-nephron glomerular filtration rate (GFR) that occurs in both physiological states and pathological states. Whole-kidney GHF is often used as a surrogate for single-nephron hyperfiltration since determining single-nephron GFR is impossible in routine clinical care. A clear definition (read threshold) of GHF is lacking. The aim of the first part of this review was to find evidence for defining the threshold for GHF, based on literature review, including systematic reviews and meta-analysis data, with both measured and estimated GFR. The consensus pediatric threshold for GHF as obtained from reviews, measured and estimated GFR studies, can reliably be set to 135 mL/min/1.73 m2 for children aged > 2 years. Diagnosing GHF from SCr-based estimated GFR is not reliable in subjects with reduced muscle mass. In these cases, it could be of interest to confirm the state of GHF using cystatin C-based eGFR, or preferably, by measured GFR, using methods that are accurate in the high GFR-range.

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Author information

Authors and Affiliations

  1. Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium

    Hans Pottel

  2. Center of Vascular and Molecular Biology, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Campus Gasthuisberg, Leuven, Belgium

    Oyindamola C. Adebayo

  3. Laboratory of Pediatric Nephrology, Department of Development and Regeneration, Katholieke Universiteit Leuven, Campus Gasthuisberg, Leuven, Belgium

    Oyindamola C. Adebayo & Agathe B. Nkoy

  4. Division of Nephrology, Department of Pediatrics, Faculty of Medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo

    Agathe B. Nkoy

  5. Department of Nephrology-Dialysis-Transplantation, University of Liège (ULiege), CHU Sart Tilman, Liège, Belgium

    Pierre Delanaye

  6. Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France

    Pierre Delanaye

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  1. Hans Pottel
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  2. Oyindamola C. Adebayo
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  3. Agathe B. Nkoy
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  4. Pierre Delanaye
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Correspondence to Hans Pottel.

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Pottel, H., Adebayo, O.C., Nkoy, A.B. et al. Glomerular hyperfiltration: part 1 — defining the threshold — is the sky the limit?. Pediatr Nephrol 38, 2523–2527 (2023). https://doi.org/10.1007/s00467-022-05827-4

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  • DOI: https://doi.org/10.1007/s00467-022-05827-4

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