Prevalence of hyperfiltration among US youth/young adults with overweight and obesity: A population-based association study

Objective: Determine prevalence of hyperfiltration (high estimated glomerular filtration rate "eGFR" >95th percentile for age/sex) among youth and association with BMI classification. Methods: With the use of 1999 to 2016 National Health and Nutrition Examination Survey data from 12- to 29-year-olds, data for serum creatinine and thresholds for high eGFR were normed using a metabolically healthy subsample (no albuminuria, healthy weights, normal blood pressures, blood glucoses, lipids, and liver enzymes). Logistic regression examined the association of BMI classification (healthy weight, overweight, and obesity classes 1-3) with hyperfiltration (eGFR > 95th percentile for age/sex), adjusted for diabetes and other covariates. Results: Of 12- to 29-year-olds (N = 18 698), 27.4% (n = 5493) met criteria for entry into the "healthy subsample" and contributed data to derive normative values for serum creatinine/hyperfiltration thresholds. In the full sample, hyperfiltration prevalence in 12- to 29-year-olds classified as healthy-weight, overweight, and obesity classes 1 to 3 was 4.9%, 4.7%, 6.5%, 8.7%, and 11.8%, respectively (P <.001). In multivariable analysis, obesity classes 2 and 3 were associated with greater likelihood of hyperfiltration (adjusted ORs for class 2: 1.5, 95% CI, 1.1-2.1; and for class 3, 2.1, 95% CI, 1.5-2.9). Diabetes also was associated with hyperfiltration (AOR, 4.0; 95% CI, 2.2-7.4). Conclusion: Obesity classes 2 to 3 are associated with hyperfiltration in youth. Age/sex-specific norms for creatinine and hyperfiltration thresholds may aid recognition of kidney dysfunction early.