{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:01:07Z","timestamp":1790787667619,"version":"4.1.0"},"reference-count":37,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ricerca Finalizzata","award":["RF-2021-12374481"],"award-info":[{"award-number":["RF-2021-12374481"]}]},{"name":"University of Milan, Italy","award":["RF-2021-12374481"],"award-info":[{"award-number":["RF-2021-12374481"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Glomerular hyperfiltration (GH) is an increase in the glomerular filtration rate, possibly progressing to chronic kidney disease (CKD). Metabolic-associated steatotic liver disease (MASLD) is linked to an increased risk of CKD, especially if fibrosis is present; however, the association between GH and MASLD has not been explored. To evaluate GH prevalence in MASLD and its possible correlation with liver fibrosis. 772 consecutive patients with ultrasound MASLD (mean age 47.3 \u00b1 8.9 years, 67.1% males) were enrolled. GH was defined as estimated glomerular filtration rate (eGFR) greater than the upper quartile of values in the cohort. Liver stiffness measurement (LSM) by FibroScan \u2265 7.2 kPa suggested liver fibrosis. GH was present in 20% of patients, liver fibrosis in 30%. In total, 53.4% of the cohort was obese, 40.9% hypertensive, 36.3% diabetic and 70.8% dyslipidaemic. GH patients compared to non-GH were significantly younger (38.4 \u00b1 8.3 vs. 49.5 \u00b1 7.7, p &lt; 0.001), with higher prevalence of LSM &gt; 7.2 kPa (35.5% vs. 29%, p &lt; 0.001), without any difference in metabolic comorbidities. In multivariate analysis, age (OR 0.85, CI 95% 0.82\u20130.87) and significant fibrosis (OR 1.83; CI 95%1.10\u20133.03) remained independently associated with GH, regardless of the presence of metabolic alterations and nephrotoxic drugs. GH, an early marker of renal damage, is highly prevalent in MASLD and is associated with hepatic fibrosis. GH may be considered an early marker of both liver and renal disease and its recognition could prompt the management of risk factors aimed at preventing the progression of both hepatic and renal disease.<\/jats:p>","DOI":"10.3390\/ijms242115837","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T11:16:27Z","timestamp":1698750987000},"page":"15837","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0402-4176","authenticated-orcid":false,"given":"Andrea","family":"Dalbeni","sequence":"first","affiliation":[{"name":"General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Garbin","sequence":"additional","affiliation":[{"name":"General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2391-1689","authenticated-orcid":false,"given":"Mirko","family":"Zoncap\u00e8","sequence":"additional","affiliation":[{"name":"General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Romeo","sequence":"additional","affiliation":[{"name":"General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Cattazzo","sequence":"additional","affiliation":[{"name":"General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4657-0784","authenticated-orcid":false,"given":"Anna","family":"Mantovani","sequence":"additional","affiliation":[{"name":"General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"},{"name":"UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8116-9307","authenticated-orcid":false,"given":"Annalisa","family":"Cespiati","sequence":"additional","affiliation":[{"name":"SC Medicina ad Indirizzo Metabolico, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano, Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5918-0171","authenticated-orcid":false,"given":"Anna Ludovica","family":"Fracanzani","sequence":"additional","affiliation":[{"name":"SC Medicina ad Indirizzo Metabolico, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano, Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Tsochatzis","sequence":"additional","affiliation":[{"name":"UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sacerdoti","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-6329","authenticated-orcid":false,"given":"Alessandro","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-927X","authenticated-orcid":false,"given":"Rosa","family":"Lombardi","sequence":"additional","affiliation":[{"name":"UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London NW3 2PF, UK"},{"name":"SC Medicina ad Indirizzo Metabolico, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano, Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","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":"ref_2","doi-asserted-by":"crossref","unstructured":"Abbate, M., Mascar\u00f3, C.M., Montemayor, S., Casares, M., G\u00f3mez, C., Ugarriza, L., Tejada, S., Abete, I., Zulet, M.A., and Sureda, A. (2021). Non-Alcoholic Fatty Liver Disease Is Associated with Kidney Glomerular Hyperfiltration in Adults with Metabolic Syndrome. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081717"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1681\/ASN.2014010115","article-title":"Renal hyperfiltration as a novel marker of all-cause mortality","volume":"26","author":"Park","year":"2015","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kang, M.W., Park, S., Lee, S., Lee, Y., Cho, S., Han, K., Cho, H., Kim, Y., Kim, Y.C., and Han, S.S. (2020). Glomerular hyperfiltration is associated with dementia: A nationwide population-based study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0228361"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kim, C.-W., Chang, Y., Sung, E., Yun, K.E., Jung, H.-S., Ko, B.-J., Kwon, M.-J., Hyun, Y.Y., Lee, K.-B., and Kim, H. (2017). Sleep duration and quality in relation to chronic kidney disease and glomerular hyperfiltration in healthy men and women. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0175298"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1158\/1055-9965.EPI-20-0078","article-title":"Glomerular hyperfiltration and cancer: A nationwide population-based study","volume":"29","author":"Kim","year":"2020","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s00247-016-3733-5","article-title":"Glomerular hyperfiltration in children with cancer: Prevalence and a hypothesis","volume":"47","author":"Kwatra","year":"2017","journal-title":"Pediatr. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1016\/j.jhep.2014.12.012","article-title":"NAFLD: A multisystem disease","volume":"62","author":"Byrne","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_9","first-page":"101133","article-title":"A Multi-Society Delphi Consensus Statement on New Fatty Liver Disease Nomenclature","volume":"29","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Mantovani, A., Lombardi, R., Cattazzo, F., Zusi, C., Cappelli, D., and Dalbeni, A. (2022). MAFLD and CKD: An Updated Narrative Review. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23137007"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Mantovani, A., and Dalbeni, A. (2021). Treatments for NAFLD: State of Art. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22052350"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Musso, G., Gambino, R., Tabibian, J.H., Ekstedt, M., Kechagias, S., Hamaguchi, M., Hultcrantz, R., Hagstr\u00f6m, H., Yoon, S.K., and Charatcharoenwitthaya, P. (2014). Association of non-alcoholic fatty liver disease with chronic kidney disease: A systematic review and meta-analysis. PLoS Med., 11.","DOI":"10.1371\/journal.pmed.1001680"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1053\/j.ajkd.2014.05.019","article-title":"CKD and nonalcoholic fatty liver disease","volume":"64","author":"Targher","year":"2014","journal-title":"Am. J. Kidney Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.metabol.2017.11.003","article-title":"Nonalcoholic fatty liver disease increases risk of incident chronic kidney disease: A systematic review and meta-analysis","volume":"79","author":"Mantovani","year":"2018","journal-title":"Metabolism"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1136\/gutjnl-2020-323082","article-title":"Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: An updated meta-analysis","volume":"71","author":"Mantovani","year":"2022","journal-title":"Gut"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"F817","DOI":"10.1152\/ajprenal.2000.278.5.F817","article-title":"Glomerular hemodynamics in severe obesity","volume":"278","author":"Chagnac","year":"2000","journal-title":"Am. J. Physiol. Renal. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1681\/ASN.2006010097","article-title":"Screening, monitoring, and treatment of albuminuria: Public health perspectives","volume":"17","author":"Curhan","year":"2006","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_18","doi-asserted-by":"crossref","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":"ref_19","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1002\/hep.27368","article-title":"Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up","volume":"61","author":"Ekstedt","year":"2015","journal-title":"Hepatology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1111\/apt.15219","article-title":"Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease","volume":"49","author":"Buzzetti","year":"2019","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jpeds.2020.03.038","article-title":"Glomerular Hyperfiltration Is Associated with Liver Disease Severity in Children with Nonalcoholic Fatty Liver Disease","volume":"222","author":"Yodoshi","year":"2020","journal-title":"J. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"110729","DOI":"10.1016\/j.diabres.2023.110729","article-title":"MAFLD and glomerular hyperfiltration in subjects with prediabetes, visceral obesity and \u201cpreserved\u201d kidney function: A cross-sectional study","volume":"201","author":"Parvanova","year":"2023","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Koo, D.-J., Lee, M.Y., Jung, I., Moon, S.J., Kwon, H., Rhee, E.-J., Park, C.-Y., Lee, W.-Y., Oh, K.W., and Park, S.E. (2022). Increased Risk of NAFLD in Adults with Glomerular Hyperfiltration: An 8-Year Cohort Study Based on 147,162 Koreans. J. Pers. Med., 12.","DOI":"10.3390\/jpm12071142"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e2021001","DOI":"10.4178\/epih.e2021001","article-title":"Renal hyperfiltration, fatty liver index, and the hazards of all-cause and cardiovascular mortality in Finnish men","volume":"43","author":"Setti","year":"2020","journal-title":"Epidemiol. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.2215\/CJN.06870909","article-title":"Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size","volume":"5","author":"Michels","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Association for the Study of the Liver, Association for the Study of Diabetes, and Association for the Study of Obesity (2016). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J. Hepatol., 64, 1388\u20131402.","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"ref_27","first-page":"3","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH)","volume":"19","author":"Williams","year":"2018","journal-title":"G Ital. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.atherosclerosis.2019.09.013","article-title":"News from ESC congress 2019: New ESC\/EAS guidelines for dyslipidaemia management published","volume":"291","author":"Stock","year":"2019","journal-title":"Atherosclerosis"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"10","DOI":"10.2337\/cd20-as01","article-title":"Standards of Medical Care in Diabetes-2020 Abridged for Primary Care Providers","volume":"38","year":"2020","journal-title":"Clin. Diabetes"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"957437","DOI":"10.3389\/fmed.2022.957437","article-title":"Impact of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) GFR Estimating Equations on CKD Prevalence and Classification Among Asians","volume":"9","author":"Betzler","year":"2022","journal-title":"Front. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Redal-Baigorri, B., Rasmussen, K., and Heaf, J.G. (2013). The use of absolute values improves performance of estimation formulae: A retrospective cross sectional study. BMC Nephrol., 14.","DOI":"10.1186\/1471-2369-14-271"},{"key":"ref_32","first-page":"303","article-title":"A formula to estimate the approximate surface area if height and weight be known. 1916","volume":"5","year":"1989","journal-title":"Nutrition"},{"key":"ref_33","doi-asserted-by":"crossref","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":"ref_34","doi-asserted-by":"crossref","unstructured":"Bozic, D., Podrug, K., Mikolasevic, I., and Grgurevic, I. (2022). Ultrasound Methods for the Assessment of Liver Steatosis: A Critical Appraisal. Diagnostics, 12.","DOI":"10.3390\/diagnostics12102287"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"6053","DOI":"10.3748\/wjg.v25.i40.6053","article-title":"Ultrasound-based techniques for the diagnosis of liver steatosis ORCID number","volume":"25","author":"Ferraioli","year":"2019","journal-title":"World J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1053\/j.ajkd.2003.11.017","article-title":"A critical appraisal for definition of hyperfiltration","volume":"43","year":"2004","journal-title":"Am. J. Kidney Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1136\/gut.2005.069153","article-title":"Diagnosis of cirrhosis by transient elastography (FibroScan): A prospective study","volume":"55","author":"Foucher","year":"2006","journal-title":"Gut"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/21\/15837\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:15:10Z","timestamp":1760130910000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/21\/15837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,31]]},"references-count":37,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["ijms242115837"],"URL":"https:\/\/doi.org\/10.3390\/ijms242115837","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,31]]}}}