{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:31:53Z","timestamp":1782318713603,"version":"3.54.5"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Glomerular hyperfiltration is a well-recognized early abnormality in diabetes and obesity but remains underappreciated in clinical nephrology. Particularly in the context of \u201cdiabesity\u201d, the merging of type 2 diabetes and obesity, glomerular hyperfiltration may represent an early and potentially reversible contributor to kidney injury. Despite its strong association with albuminuria and decline in glomerular filtration rate (GFR), hyperfiltration is not included in chronic kidney disease (CKD) staging systems, nor routinely flagged by laboratory systems. The lack of a universally accepted definition, along with the absence of easy-to-use diagnostic tools, contributes to its under recognition. However, recent clinical evidence, including our own prospective studies, highlights the prognostic importance of glomerular hyperfiltration and suggests the need to integrate it into risk stratification frameworks. Here, we advocate for the re-evaluation of hyperfiltration in diabesity as a clinically relevant phenotype, we propose practical approaches to identify it in daily practice, including percentile-based thresholds, protein loading tests, and intra-parenchymal renal resistive index variation, and outline a path toward its clinical recognition and therapeutic targeting.<\/jats:p>","DOI":"10.1093\/joneph\/aajaf055","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T17:30:31Z","timestamp":1776447031000},"page":"76-79","source":"Crossref","is-referenced-by-count":1,"title":["Glomerular hyperfiltration in diabesity: an overlooked target for early intervention"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1223-0167","authenticated-orcid":false,"given":"Diego","family":"Moriconi","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"2026060416144793900_aajaf055-B1","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1038\/s41569-020-00465-5","article-title":"Diabesity: the combined burden of obesity and diabetes on heart disease and the role of imaging","volume":"18","author":"Ng","year":"2021","journal-title":"Nat Rev Cardiol"},{"key":"2026060416144793900_aajaf055-B2","doi-asserted-by":"publisher","first-page":"845","DOI":"10.2337\/dc22-2003","article-title":"Glomerular hyperfiltration predicts kidney function decline and mortality in type 1 and type 2 diabetes: a 21-year longitudinal study","volume":"46","author":"Moriconi","year":"2023","journal-title":"Diabetes Care"},{"key":"2026060416144793900_aajaf055-B3","doi-asserted-by":"publisher","first-page":"2061","DOI":"10.2337\/dc11-2189","article-title":"Glomerular hyperfiltration and renal disease progression in type 2 diabetes","volume":"35","author":"Ruggenenti","year":"2012","journal-title":"Diabetes Care"},{"key":"2026060416144793900_aajaf055-B4","doi-asserted-by":"publisher","first-page":"e202377","DOI":"10.1001\/jamanetworkopen.2020.2377","article-title":"Association of glomerular hyperfiltration and cardiovascular risk in middle-aged healthy individuals","volume":"3","author":"Dupuis","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2026060416144793900_aajaf055-B5","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.kint.2017.07.013","article-title":"Glomerular hyperfiltration is a predictor of adverse cardiovascular outcomes","volume":"93","author":"Reboldi","year":"2018","journal-title":"Kidney Int"},{"key":"2026060416144793900_aajaf055-B6","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.1111\/dom.15465","article-title":"Age- and gender-adjusted estimated glomerular filtration rate definition reveals hyperfiltration as a risk factor for renal function deterioration in type 2 diabetes","volume":"26","author":"Wen","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"2026060416144793900_aajaf055-B7","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1038\/s41581-022-00559-y","article-title":"Glomerular hyperfiltration","volume":"18","author":"Cortinovis","year":"2022","journal-title":"Nat Rev Nephrol"},{"key":"2026060416144793900_aajaf055-B8","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1111\/nep.14077","article-title":"Glomerular hyperfiltration in morbid obesity: role of the inflammasome signalling","volume":"27","author":"Moriconi","year":"2022","journal-title":"Nephrology"},{"key":"2026060416144793900_aajaf055-B9","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1038\/s41581-018-0080-9","article-title":"Estimated GFR: time for a critical appraisal","volume":"15","author":"Porrini","year":"2019","journal-title":"Nat Rev Nephrol"},{"key":"2026060416144793900_aajaf055-B10","doi-asserted-by":"publisher","first-page":"R690","DOI":"10.1152\/ajpregu.00237.2020","article-title":"Renal functional reserve: from physiological phenomenon to clinical biomarker and beyond","volume":"319","author":"Jufar","year":"2020","journal-title":"Am J Physiol Regul Integr Comp Physiol."},{"key":"2026060416144793900_aajaf055-B11","doi-asserted-by":"publisher","first-page":"286","DOI":"10.3389\/fphys.2016.00286","article-title":"Intra-parenchymal renal resistive Index variation (IRRIV) describes renal functional reserve (RFR): pilot study in healthy volunteers","volume":"7","author":"Samoni","year":"2016","journal-title":"Front Physiol"},{"key":"2026060416144793900_aajaf055-B12","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s40620-020-00786-1","article-title":"The relationship between intra-parenchymal renal resistive index variation and renal functional reserve in healthy subjects","volume":"34","author":"Samoni","year":"2021","journal-title":"J Nephrol"},{"key":"2026060416144793900_aajaf055-B13","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/0002-9343(84)90529-1","article-title":"Short-term protein \u00adloading in assessment of patients with renal disease","volume":"77","author":"Bosch","year":"1984","journal-title":"Am\u00a0J Med"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/39\/1\/76\/68108184\/aajaf055.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/39\/1\/76\/68108184\/aajaf055.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T20:14:54Z","timestamp":1780604094000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/39\/1\/76\/8658473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,4,17]]},"published-print":{"date-parts":[[2026,6,4]]}},"URL":"https:\/\/doi.org\/10.1093\/joneph\/aajaf055","relation":{},"ISSN":["1121-8428","1724-6059"],"issn-type":[{"value":"1121-8428","type":"print"},{"value":"1724-6059","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2026,1]]}}}