Accessing the relationship between estimated glucose disposal rate and the incidence of the kidney disease: results from the China Health and Retirement Longitudinal Study

Recent studies have closely linked estimated glucose disposal rate (eGDR) to cardiovascular events; however, research on eGDR in chronic kidney disease (CKD) is limited. This study aimed to explore the relationship between eGDR and kidney diseases, including rapid kidney function decline (RKFD) and new-onset CKD (NOCKD), in a non-CKD population. We examined 5,679 non-CKD individuals from the China Health and Retirement Longitudinal Study (2011-2015) with complete eGDR data. Participants were categorized into four groups based on eGDR quartiles. Logistic regression and restricted cubic spline (RCS) were utilized to assess the correlation between eGDR and the incidence of RKFD and NOCKD. Subgroup analyses and optimization of predictive models were conducted based on baseline characteristics of participants. During follow-up, 402 RKFD and 220 NOCKD cases were documented. Higher eGDR was associated with reduced risk of RKFD (OR: 0.87, 95% CI: 0.81-0.94, p < 0.001) and NOCKD (OR: 0.88, 95% CI: 0.80-0.97, p = 0.01) per 1.0-SD increment. Restricted cubic splines models showed a linear relationship (non-linear p > 0.05), with increased RKFD/NOCKD risk when eGDR < 10.405 mg/kg/min. Adding eGDR improved predictive ability for RKFD (AUC: 0.659 vs. 0.672, p = 0.012) and NOCKD (AUC: 0.532 vs. 0.539, p = 0.004). This study demonstrated that lower eGDR levels in Chinese participants aged over 45 years without CKD are associated with an increased risk of developing RKFD and NOCKD.