Association of baseline and changes in estimated glucose disposal rate and risk of chronic kidney disease: evidence from a national longitudinal study.

OBJECTIVE

This study explored the relationship between baseline estimated glucose disposal rate (eGDR), its trajectories, and the risk of chronic kidney disease (CKD).

METHODS

Participants from the China Health and Retirement Longitudinal Study were included. eGDR was calculated using a validated formula, and CKD was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73m2 or self-reported. Group-based trajectory modeling identified distinct eGDR patterns, and Cox proportional hazards models assessed associations between eGDR and CKD risk.

RESULTS

A total of 5,238 participants were analyzed, with 436 incident CKD cases during the 5-year follow-up. Higher baseline eGDR (≥ 8 mg/kg/min) was associated with a reduced CKD risk (Hazard Ratio [HR] = 0.40; 95% Confidence Interval [CI]: 0.19-0.88; P = 0.022). An L-shaped relationship was observed between eGDR and CKD risk. Three eGDR trajectories were identified: low-stability (41.8%), decreasing (14.5%), and high-stability (43.7%). Only the high-stability trajectory significantly reduced CKD risk (HR = 0.77; 95% CI: 0.62-0.96; P = 0.019) compared to the low-stability group.

CONCLUSION

Higher baseline eGDR and consistently high eGDR trajectories were linked to a lower CKD risk, highlighting the significance of maintaining insulin sensitivity for CKD prevention.