From the Guidelines
An elevated Glomerular Filtration Rate (GFR) and elevated globulin level may indicate hyperfiltration and possible inflammation or infection.
Key Points
- Hyperfiltration is generally accepted as a concept, but not consistently defined, with a possible threshold of GFR >120 ml/min per 1.73 m2 1.
- Elevated globulin levels can be associated with various conditions, including inflammation, infection, or liver disease.
- The GFR categories defined by the Kidney Disease: Improving Global Outcomes (KDIGO) consensus conference can help in understanding the level of kidney function, with normal to increased GFR being G1 GFR ≥90 ml/min per 1.73 m2 1.
- The presence of kidney damage and level of kidney function, determined by GFR, are used to establish the presence of Chronic Kidney Disease (CKD) and assign the stage of disease 1.
- It is essential to consider the clinical context and other laboratory results when interpreting elevated GFR and globulin levels, as they can have various implications, including cardiovascular disease outcome risk factor 1.
Important Considerations
- GFR is an important measure of kidney function, and its estimation should be based on prediction equations that take into account serum creatinine concentration and other variables such as age, sex, race, and body size 1.
- Albuminuria and proteinuria are also important markers of kidney damage and should be considered in the assessment of kidney function 1.
From the Research
Elevated Glomerular Filtration Rate (GFR) and Globulin Level
- An elevated GFR can indicate renal hyperfiltration, which is associated with early phases of kidney disease in conditions such as obesity and diabetes 2.
- Renal hyperfiltration is also linked to a higher risk of cardiovascular disease and all-cause mortality 2.
- Glomerular hyperfiltration can occur in healthy individuals after high protein intake, during pregnancy, and in patients with diabetes, obesity, or autosomal-dominant polycystic kidney disease 3.
Globulin Level
- Elevated globulin levels can be associated with various conditions, including malignant proliferative disorders and systemic lupus erythematosus (SLE) 4.
- Beta2-microglobulin, a type of globulin, is constantly produced in the body and eliminated by the kidneys, with its serum level influenced by the GFR 4.
- An increased excretion of beta2-microglobulin in the urine can indicate proximal tubular dysfunction in many clinical conditions 4.
Relationship between GFR and Globulin Level
- A high GFR can be defined by different thresholds, including the 95th percentile for measured GFR (mGFR) or estimated GFR (eGFR) 5.
- The association between high GFR and clinical characteristics, such as single-nephron GFR, glomerular volume, and kidney volume, can vary depending on the definition used 5.
- Higher baseline GFR may be associated with a subsequent steeper GFR decline, especially in patients with diabetes mellitus (DM) 6.