Baynouna AlKetbi Latifa Mohammad, Boobes Yousef, Afandi Bachar, Aleissaee Hamda, AlShamsi Noura, AlMansoori Mohammed, Hemaid Ahmed, AlDobaee Muna Jalal, AlAlawi Noura, AlKetbi Rudina Mubarak, Fahmawee Toqa, AlHashaikeh Basil, AlAzeezi AlYazia, Shuaib Fatima, Alnuaimi Jawaher, Mahmoud Esraa, AlAhbabi Nayla, Nagelkerke Nico
Ambulatory Healthcare Services, SEHA, Abu Dhabi, United Arab Emirates.
College of Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.
J Nephrol. 2025 Aug 5. doi: 10.1007/s40620-025-02347-w.
The impact of reduced kidney function quantified by estimated Glomerular Filtration Rate (eGFR) on various adverse clinical outcomes has been extensively studied. This study aims to estimate the age and sex-specific eGFR in the Abu Dhabi population and its association with adverse outcomes.
This is a retrospective cohort study conducted in 8699 participants enrolled in a national cardiovascular disease screening program from 2011 to 2013. A reference eGFR percentile was estimated from healthy cohort members who had no comorbidities. The LMS (Lambda, Mu, and Sigma) method was used to determine these percentiles. The cohort was reassessed in 2023 for mortality and cardiovascular outcomes.
The reference percentiles of normal eGFR values showed a marked decrease with age, with small sex differences in the reference percentile distribution. Subjects in the two categories within the higher eGFR threshold range, the 95th and 97th percentiles were older, had a significantly higher prevalence of diabetes, were more frequently smokers, and had higher body mass index, higher HbA1c, higher HDL, lower vitamin D, and were more likely to be males, with higher physical activity and a lower prevalence of coronary heart disease. Older age, female sex, history of atherosclerotic cardiovascular disease, history of hypertension, being treated for hypertension, lower diastolic blood pressure, higher systolic blood pressure, lower HDL, higher HbA1c, and higher vitamin D were significantly associated with lower eGFR percentiles.
These ethnicity-specific eGFR reference values are valuable for the early identification of patients with chronic kidney disease, allowing for early qualification for beneficial preventive medication, evaluations, and nephrologist referrals. A prognostic definition of the higher eGFR threshold, as renal hyperfiltration, is suggested since the 97th percentile had a significantly higher incidence of atherosclerotic cardiovascular disease.
通过估算肾小球滤过率（eGFR）量化的肾功能降低对各种不良临床结局的影响已得到广泛研究。本研究旨在估算阿布扎比人群中按年龄和性别划分的eGFR及其与不良结局的关联。
这是一项回顾性队列研究，研究对象为2011年至2013年参加全国心血管疾病筛查项目的8699名参与者。从无合并症的健康队列成员中估算参考eGFR百分位数。采用LMS（λ、μ和σ）方法确定这些百分位数。2023年对该队列进行重新评估，以了解死亡率和心血管结局。
正常eGFR值的参考百分位数随年龄显著下降，参考百分位数分布存在微小性别差异。在较高eGFR阈值范围（第95和第97百分位数）内的两类受试者年龄较大，糖尿病患病率显著更高，吸烟更频繁，体重指数更高，糖化血红蛋白更高，高密度脂蛋白更高，维生素D更低，男性比例更高，身体活动水平更高，冠心病患病率更低。年龄较大、女性、有动脉粥样硬化性心血管疾病史、有高血压病史、正在接受高血压治疗、舒张压较低、收缩压较高、高密度脂蛋白较低、糖化血红蛋白较高和维生素D较高与较低的eGFR百分位数显著相关。
这些特定种族eGFR参考值对于早期识别慢性肾脏病患者具有重要价值，有助于早期确定是否适合使用有益的预防性药物、进行评估以及转诊至肾病专家。由于第97百分位数的动脉粥样硬化性心血管疾病发病率显著更高，建议将较高eGFR阈值定义为肾高滤过的预后指标。
