Estimation of age and sex specific Glomerular Filtration Rate in the Abu Dhabi population and its association with mortality and Atherosclerotic cardiovascular outcome. A Retrospective Cohort Study

Abstract

The impact of abnormal Glomerular Filtration Rate (eGFR) on various adverse outcomes has been well studied; however, the United Arab Emirates (UAE), like many other regions in the world, remains understudied in this area. Method This retrospective cohort study estimates the age and sex-specific Glomerular Filtration Rate (eGFR) in the Abu Dhabi population and its association with mortality and Atherosclerotic cardiovascular (ASCVD) outcomes. The cohort of 8699 participants in a national cardiovascular disease screening from 2011 to 2013. The cohort was reevaluated in 2023 for mortality and cardiovascular outcomes. Reference eGFR percentiles were estimated from subjects without comorbidities using the LMS method. Results The reference percentiles of normal eGFR values showed a marked decrease with age, with small sex differences in the reference percentile distribution. A prognostic definition of renal hyperfiltration (RH) is suggested by the observation that subjects in the 97th percentile had a significantly higher incidence of ASCVD, although not statistically significant, in terms of mortality rate. Older age, female sex, history of ASCVD, history of hypertension, being treated for hypertension, lower diastolic blood pressure, higher systolic blood pressure, lower HDL, higher HA1C, and higher vitamin D were significantly associated with lower eGFR percentiles. Subjects in the two categories within the RH range, the 95th and 97th percentiles, had a significantly higher prevalence of diabetes; they are older smokers with higher BMI, higher HA1C, higher HDL, lower vitamin D, and more likely to be males, with higher physical activity and have a lower prevalence of CHD. Conclusion The distribution of eGFR by age and sex is valuable for clinical decision-making in Abu Dhabi and likely for the Arab population in general. Although the 95th percentile of eGFR in this cohort showed a higher but nonsignificant risk, the 97th percentile is significantly associated with ASCVD, even more than subjects in the less than 10th eGFR percentile. This study provides important insights into the prevalence and risk factors associated with different eGFR percentiles in the Abu Dhabi population. The findings underscore the need for targeted interventions to address modifiable risk factors and prevent the progression of renal damage in this high-risk population.