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How kidney clock works: circadian pattern of eGFR based on a population data group

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Abstract

A circadian regulation of renal function it has been described in the last few years. An intradaily variation in glomerular filtration rate (eGFR) has also been discovered at the individual level. The aim of this study was to check if there exists a circadian pattern of eGFR at population data group level and to compare the population results with those described at individual level. We have studied a total of 446,441 samples analysed in the emergency laboratories of two Spanish hospitals between January 2015 and December 2019. We selected all the records of eGFR values between 60 and 140 mL/min/1.73 m2 using CKD-EPI formula from patients between 18 and 85 years. The intradaily intrinsic eGFR pattern was computed using the extraction time of day in four nested mixed linear and sinusoidal regression models. All models showed an intradaily eGFR pattern, but the estimated model coefficients differed depending on whether age was included. The inclusion of age improved the performance of the model. In this model, the acrophase occurred at 7:46 h. We describe the distribution of eGFR values depending on the time in two different populations. This distribution is adjusted to a circadian rhythm that behaves similarly to the individual rhythm. This pattern is similar in each of the years studied from each hospital as well as between both hospitals. The results found suggest the incorporation of the concept of “population circadian rhythm” into the scientific world.

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Acknowledgments

We thank Dr. Francisco Jose García García (Toledo Study of Healthy Aging. CIBERFES (ISCIII)) for introducing the authors of the study and listening to our ideas. We thank to the Spanish Research Group in Biological Rhythms and Laboratory Medicine for being the link to carry out the study.

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Lorenzo-Lozano, Blázquez-Manzanera and Carnicero have contributed equally as first authors. The authors declare that all data were generated in-house.

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Correspondence to MC. Lorenzo-Lozano.

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The study has been approved by the Ethics Committee for Clinical Research with Medicines of the University Hospital of Toledo with registration number 948. The study presented was performed with the Standards of Good Clinical Practice, the fundamental ethical principles established in the 1964 Declaration of Helsinki and its later amendments, the Oviedo Convention, as well as the requirements established in Spanish legislation.

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The authors declare no competing interests.

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Key points

• There is a circadian rhythm in the laboratory values analysed from a population data set.

• A disadvantage of chronobiology is the collection of individual 24-h data.

• Studying circadian patterns at the population level is a major step in chronobiology.

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Lorenzo-Lozano, M., Blázquez-Manzanera, A. & Carnicero, J. How kidney clock works: circadian pattern of eGFR based on a population data group. J Physiol Biochem 79, 543–554 (2023). https://doi.org/10.1007/s13105-023-00948-2

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  • DOI: https://doi.org/10.1007/s13105-023-00948-2

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