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The primary cause of the lack of clarity surrounding the GFR levels that indicate hyperfiltration is their strong reliance on age. [12] Glomerular hyperfiltration has traditionally been characterized as an elevated whole-kidney GFR, or a GFR greater than two standard deviations above the mean GFR of healthy individuals.
Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman's capsule per unit time. [4] Central to the physiologic maintenance of GFR is the differential basal tone of the afferent (input) and efferent (output) arterioles (see diagram).
The normal range of GFR, adjusted for body surface area, is 100–130 average 125 (mL/min)/(1.73 m 2) in men and 90–120 (mL/min)/(1.73 m 2) in women younger than the age of 40. In children, GFR measured by inulin clearance is 110 (mL/min)/(1.73 m 2 ) until 2 years of age in both sexes, and then it progressively decreases.
Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. [5] [6] Risk factors include a family history of chronic kidney disease. [2] Diagnosis is by blood tests to measure the estimated glomerular filtration rate (eGFR), and a urine test to measure albumin. [8]
Out of the 1,374,392 female deaths reported in the US in 2017, kidney disease was listed as the cause of death for 24,889 women and was reported as the 9th overall cause of death for women in 2017. [45] Out of the 1,439,111 male deaths reported in the US in 2017, kidney disease was not listed in the top 10 causes of death. [45]
It is characterized clinically by a rapid decrease in the glomerular filtration rate (GFR) by at least 50% over a short period, usually from a few days to 3 months. [23] They are considered to be "diagnoses of exclusion", i.e. they are diagnosed only after secondary causes have been excluded.
In the United States, acute failure affects about 3 per 1,000 people a year. [8] Chronic failure affects about 1 in 1,000 people with 3 per 10,000 people newly developing the condition each year. [1] [10] In Canada, the lifetime risk of kidney failure or end-stage renal disease (ESRD) was estimated to be 2.66% for men and 1.76% for women. [11]
Diabetic nephropathy, also known as diabetic kidney disease, [5] is the chronic loss of kidney function occurring in those with diabetes mellitus.Diabetic nephropathy is the leading causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) globally.