ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2025
High measured GFR as a predictor of all-cause mortality and cardiovascular disease in a prospective non-diabetic population cohort.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glomerular hyperfiltration defined by eGFR and long-term clinical outcomes: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Higher habitual protein intake is not linked to decline of iohexol-measured GFR in adults ≥40 years.Clinical kidney journal · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundHigh glomerular filtration rate (GFR) is generally regarded as beneficial but has been associated with cardiovascular disease (CVD) and all-cause mortality in epidemiological studies. However, these investigations may have been biased by the non-GFR determinants of estimated GFR (eGFR). We compared the risk of high baseline iohexol clearance [measured GFR (mGFR)] and eGFR based on creatinine or cystatin C in a prospective longitudinal population-based study of the Renal Iohexol Clearance Survey (RENIS) cohort.
methodsThe cohort consists of a representative sample of the general population of persons 50-64 years of age without baseline CVD, diabetes or kidney disease in the municipality of Tromsø, Norway. We investigated non-linear associations in general additive Cox regression models adjusted for CVD risk factors.
resultsDuring a median follow-up of 14.1 years, 232 CVD outcomes and 117 deaths occurred in a study population of 1552 persons. For all-cause mortality, no association was found for mGFR, but the previously reported association between high eGFR with creatinine (eGFRcrea) and increased risk was confirmed. For the CVD outcome, the best fitting model included interactions between mGFR or eGFR and the urine albumin:creatinine ratio (ACR). An mGFR or eGFR with cystatin C (eGFRcys) >85 ml/min/1.73 m2 was associated with an elevated hazard ratio for CVD in participants with high-normal urine ACR (>10 mg/g) only.
conclusionsA high mGFR or eGFRcys is not associated with an increased risk of CVD or all-cause mortality in the general non-diabetic population with normal urine ACR. Previous findings of an association with high eGFRcrea were most likely caused by non-GFR confounders. In persons with high-normal ACR, high mGFR or eGFRcys is associated with an increased risk of CVD.
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