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Serum bilirubin level and its impact on the progression of chronic kidney disease

  • Nephrology - Original Paper
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Abstract

Purpose

To examine whether an elevated serum total bilirubin level affects the decline in renal function or new-onset chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (DM2).

Methods

This was a longitudinal observational study in patients who presented at the University of Health Sciences Hospital in Kayseri. Five hundred twenty-nine patients with DM2 who had conserved renal function were enrolled (estimated glomerular filtration rate > 60 ml/min/1.73 m2). Arising CKD stage 3 was the outcome measure. The patients were separated into three groups based on the total serum bilirubin levels. The first group (G1) ranged from 0.1 to 0.3, the second (G2) 0.4–0.5, and the third (G3) 0.6–0.9 mg/dl. The effect of total serum bilirubin levels on CKD 3 development was assessed using Cox proportional hazards regression.

Results

The risk of the CKD stage 3 development was highest in G1 who has the lowest serum total bilirubin levels (G1 vs. G3; hazard ratio [HR], 2.02; 95% confidence interval [CI] 1.21–3.36; p = 0.007). In addition, G2 had a significant risk of CKD stage 3 development (G2 vs. G3; hazard ratio [HR], 1.58; 95% confidence interval [CI] 1.08–2.32; p = 0.018). In the adjusted analysis, compared to G2 and G3, G1 had the highest risk (G1 vs. G3; hazard ratio [HR], 2.20; 95% confidence interval [CI] 1.29–3.77; p = 0.004). Similarly, G2 had a higher risk compared to G3 (hazard ratio [HR], 1.57; 95% confidence interval [CI] 1.05–2.34; p = 0.028).

Conclusions

Serum bilirubin may predict the progression of CKD in patients with type 2 diabetes and preserved kidney function.

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Funding

There was no funding used in this study.

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, Health Sciences, University School of Medicine, Training and Research Hospital, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No:78., Kocasinan, 38010, Kayseri, Turkey

    Koray Uludag, Tamer Arıkan & Gulsah Boz

  2. Nephrology Section, Medicine Service, Atatürk State Hospital, Muratpaşa Mahallesi, Anafartalar Cad., Muratpaşa, 07040, Antalya, Turkey

    Nilufer Oguzhan

Authors
  1. Koray Uludag
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  2. Nilufer Oguzhan
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  4. Gulsah Boz
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Correspondence to Koray Uludag.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study (retrospective), formal consent is not required.

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Uludag, K., Oguzhan, N., Arıkan, T. et al. Serum bilirubin level and its impact on the progression of chronic kidney disease. Int Urol Nephrol 50, 1695–1701 (2018). https://doi.org/10.1007/s11255-018-1923-9

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  • DOI: https://doi.org/10.1007/s11255-018-1923-9

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