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Test tubes in a lab

Doctoral defence of Mounir Ould Setti, MD, MPH, 2 Feb 2024: Renal hyperfiltration: an underestimated risk factor for mortality

The doctoral dissertation in the field of Epidemiology will be examined at the Faculty of Health Sciences at Kuopio campus. 

What is the topic of your doctoral research? Why is it important to study the topic?

The focus of the doctoral research was on renal hyperfiltration (RHF) and its relation with other mortality risk factors with respect to mortality. The study is crucial as it challenges previous conceptions of RHF primarily as a manifestation of diabetes mellitus (DM), proposing RHF as an independent risk factor for mortality. This re-evaluation is essential for improving understanding and management of RHF and associated health risks.

What are the key findings or observations of your doctoral research?

The study suggests that the estimated glomerular filtration rate (eGFR) cut-off for defining RHF could be much lower than the cut-offs traditionally used, suggesting that a considerable proportion of apparently healthy middle-age men could have RHF and be at an increased risk for mortality.

The study also demonstrates that RHF is associated with an increased risk of mortality, regardless of DM. 

A significant discovery is the synergistic interaction between vitamin D deficiency and RHF in relation to mortality, suggesting a more complex relationship than previously understood. 

The absence of an interaction effect between RHF and fatty liver on mortality is also a notable finding. 

One of the most important findings of the study emphasizes the importance and urgency of reaching a consensual definition for RHF, in order to accurately assess the burden of this condition and to properly screen and prevent its negative effects. Even small changes in eGFR could affect mortality risk. The results also highlight the importance of considering the interactions between RHF and other conditions.

What are the key research methods and materials used in your doctoral research?

The research utilized data from a large, population-based cohort of middle-aged Finnish men from Kuopio, followed for up to 35 years. Key methods included evaluating hazards of mortality associated with different eGFR cut-offs, using Cox regression and logistic regression models, and assessing interactions between RHF and other conditions like fatty liver disease and vitamin D deficiency. The use of a counterfactual framework for mediation analysis in assessing the role of DM in the relationship between RHF and mortality represents a modern and robust approach.

The doctoral dissertation of Mounir Ould Setti, MD, MPH, entitled Renal hyperfiltration and mortality: the Kuopio Ischaemic Heart Disease risk factor study will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Professor Päivi Korhonen of the University of Turku, and the Custos will be Professor Tomi-Pekka Tuomainen of the University of Eastern Finland.

Doctoral defence 

Doctoral dissertation 

For further information, please contact:

Dr Mounir Ould Setti, mouniro(a)