• Päivi E Korhonen, Sem Kiiski, Hannu Kautiainen, Seppo Ojanen, and Risto Tertti.
• Department of General Practice, Turku University and Turku University Hospital, Turku, Finland. paivi.korhonen@utu.fi.
• J Gen Intern Med. 2023 Jun 1; 38 (8): 183418421834-1842.

BackgroundLower-than-normal estimated glomerular filtration rate (eGFR) is associated with the risk for all-cause mortality and adverse cardiovascular events. In this regard, the role of higher-than-normal eGFR is still controversial.ObjectiveInvestigate long-term clinical consequences across the levels of eGFR calculated by the creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation among apparently healthy cardiovascular risk subjects.DesignProspective study.ParticipantsParticipants (n=1747) of a population-based screening and intervention program for cardiovascular risk factors in Finland during the years 2005-2007.Main MeasuresCardiovascular morbidity and all-cause mortality.Key ResultsOver the 14-year follow-up, subjects with eGFR ≥105 ml/min/1.73 m2 (n=97) had an increased risk for all-cause mortality [HR 2.15 (95% CI: 1.24-3.73)], incident peripheral artery disease [HR 2.62 (95% CI: 1.00-6.94)], and atrial fibrillation/flutter [HR 2.10 (95% CI: 1.21-3.65)] when compared to eGFR category 90-104 ml/min after adjustment for cardiovascular and lifestyle-related risk factors. The eGFR category ≥105 ml/min was also associated with a two-fold increased mortality rate compared to the Finnish general population.ConclusionsRenal hyperfiltration defined as eGFR ≥105 ml/min/1.73 m2 is a frequent and important finding in patients commonly treated in primary care. These patients should be followed closely for timely interventions, such as strict BP and blood glucose regulation.© 2022. The Author(s).

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