Prediabetes defined by the International Expert Committee as a risk for development of glomerular hyperfiltration

Aims To clarify if prediabetes defined by the International Expert Committee (Prediabetes IEC ) and/or the American Diabetes Society (Prediabetes ADA ) is a risk for incident glomerular hyperfiltration (GH). Methods 24,524 health examinees without diabetes, chronic kidney disease (CKD), GH and antihypertensive treatment at baseline, and repeated examinations at least twice during a mean of 5.3 years were retrospectively analysed. Diabetes was defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L and/or HbA 1c ≥ 47 mmol/mol, CKD by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m 2 and/or dipstick-positive proteinuria, and GH by upper 95th eGFR in the Japanese adults. Prediabetes IEC was diagnosed by “HbA 1c 42–46 mmol/mol and/or FPG 6.1–6.9 mmol/L”, Prediabetes ADA by “HbA 1c 39–46 mmol/mol and/or FPG 5.6–6.9 mmol/L”, Prediabetes ADA−IEC for the condition met the ADA but not the IEC prediabetes definition, and the ADA-normal glucose regulation (NGR ADA ) by both HbA 1c and FPG lower than Prediabetes ADA . Risk of Prediabetes IEC and Prediabetes ADA for incident GH was examined by multivariate Cox proportional hazards model with seven covariates and probability of incident GH was calculated on the basis of it. Results Prediabetes IEC was a significant risk for incident GH [adjusted HR 1.91, 95% CI 1.32–2.71] but Prediabetes ADA was not [adjusted HR 1.22, 95% CI 0.93–1.61]. The mean (SD) probability of incident GH was 2.3 (4.5)%, 1.0 (2.3)% and 1.0 (2.4)% for Prediabetes IEC , Prediabetes ADA−IEC and NGR ADA , respectively: the former was significantly larger than the latter two which were not significantly different from each other. Conclusions Prediabetes IEC was an independent risk for incident GH.