Reduced glomerular filtration rate in individuals with intermediate hyperglycemia and type 2 diabetes as defined by 1-hour post-load glucose levels according to the newly released IDF criteria.

AIMS: Recently, the International Diabetes Federation (IDF) has recommended determination of 1 h-post-load glucose (PG) to diagnose intermediate hyperglycemia (IH) and type 2 diabetes (T2DM). Herein, we investigate the implication of IDF recommendation in identifying subjects with chronic kidney disease (CKD).

METHODS

Estimated glomerular filtration rate (eGFR) was assessed on 2161 subjects classified on the basis of their fasting, 1 h and 2 h-PG, according to the IDF criteria, as having normal glucose tolerance (NGT), isolated impaired fasting glucose (iIFG), IH and T2DM.

RESULTS

Prevalence of CKD (eGFR < 60 ml/min/1.73 m2) and mildly reduced kidney function (eGFR 90-60 ml/min/1.73 m2) progressively increased at worsening of glucose tolerance. In a logistic regression analysis adjusted for several cardio-metabolic confounders, individuals with iIFG and IH exhibited a 3.48- (95 %CI = 1.01-11.00, P = 0.05) and 3.69- (95 %CI = 1.42-9.60, P = 0.007) fold increased risk of having CKD compared to the NGT group. The risk for CKD was further increased in subjects with T2DM (OR = 3.93, 95 %CI = 1.36-10.66, P = 0.007). Additionally, participants with IH and T2DM had a 1.89-fold (95 %CI = 1.38-2.60, P < 0.0001) and 2.78-fold (95 %CI = 1.97-3.98, P < 0.0001) higher risk of mildly reduced GFR compared to the NGT group.

CONCLUSIONS

The 1 h-PG thresholds proposed by IDF as diagnostic for IH and T2DM are capable of identifying individuals at risk of kidney dysfunction.