{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:53:36Z","timestamp":1792803216351,"version":"4.5.0"},"reference-count":37,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":3277,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To describe the prevalence and determinants of hyperfiltration (glomerular filtration rate [GFR] \u2265120 mL\/min\/1.73 m2), GFR decline, and nephropathy onset or progression in type 2 diabetic patients with normo- or microalbuminuria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>We longitudinally studied 600 hypertensive type 2 diabetic patients with albuminuria &amp;lt;200 \u03bcg\/min and who were retrieved from two randomized trials testing the renal effect of trandolapril and delapril. Target blood pressure (BP) was &amp;lt;120\/80 mmHg, and HbA1c was &amp;lt;7%. GFR, albuminuria, and glucose disposal rate (GDR) were centrally measured by iohexol plasma clearance, nephelometry in three consecutive overnight urine collections, and hyperinsulinemic euglycemic clamp, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Over a median (range) follow-up of 4.0 (1.7\u20138.1) years, GFR declined by 3.37 (5.71\u20131.31) mL\/min\/1.73 m2 per year. GFR change was bimodal over time: a larger reduction at 6 months significantly predicted slower subsequent decline (coefficient: \u22120.0054; SE: 0.0009), particularly among hyperfiltering patients. A total of 90 subjects (15%) were hyperfiltering at inclusion, and 11 of 47 (23.4%) patients with persistent hyperfiltration progressed to micro- or macroalbuminuria versus 53 (10.6%) of the 502 who had their hyperfiltration ameliorated at 6 months or were nonhyperfiltering since inclusion (hazard ratio 2.16 [95% CI 1.13\u20134.14]). Amelioration of hyperfiltration was independent of baseline characteristics or ACE inhibition. It was significantly associated with improved BP and metabolic control, amelioration of GDR, and slower long-term GFR decline on follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Despite intensified treatment, patients with type 2 diabetes have a fast GFR decline. Hyperfiltration affects a subgroup of patients and may contribute to renal function loss and nephropathy onset or progression. Whether amelioration of hyperfiltration is renoprotective is worth investigating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc11-2189","type":"journal-article","created":{"date-parts":[[2012,7,6]],"date-time":"2012-07-06T20:22:56Z","timestamp":1341606176000},"page":"2061-2068","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":298,"title":["Glomerular Hyperfiltration and Renal Disease Progression in Type 2 Diabetes"],"prefix":"10.2337","volume":"35","author":[{"given":"Piero","family":"Ruggenenti","sequence":"first","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"},{"name":"Unit of Nephrology, Azienda Ospedaliera Ospedali Riuniti di Bergamo, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban L.","family":"Porrini","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Gaspari","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Motterlini","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Cannata","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Carrara","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Cella","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Stucchi","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneliya","family":"Parvanova","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilian","family":"Iliev","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro Roberto","family":"Dodesini","sequence":"additional","affiliation":[{"name":"Unit of Diabetology, Azienda Ospedaliera Ospedali Riuniti di Bergamo, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Trevisan","sequence":"additional","affiliation":[{"name":"Unit of Diabetology, Azienda Ospedaliera Ospedali Riuniti di Bergamo, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Bossi","sequence":"additional","affiliation":[{"name":"Unit of Diabetology, Treviglio Hospital, Treviglio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelka","family":"Zaletel","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Remuzzi","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Rare Diseases Aldo & Cele Dacc\u00f2, Mario Negri Institute for Pharmacological Research, 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