Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease

Teppei Sakoh, Masaru Nakayama, Shigeru Tanaka, Ryota Yoshitomi, Yoriko Ura, Hitomi Nishimoto, Akiko Fukui, Yui Shikuwa, Kazuhiko Tsuruya, Takanari Kitazono

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective Serum bilirubin has been reported to be associated with the progression of kidney disease in patients with diabetic nephropathy. Less is known, however, about the relationship between bilirubin and chronic kidney disease (CKD) of other etiologies. This study was designed to clarify whether serum total bilirubin concentration is associated with kidney disease progression in patients with CKD independent of etiology. Materials and methods This prospective observational study enrolled 279 consecutive patients with stages 3-5 CKD. The renal endpoint was the composite of the doubling of serum creatinine or end-stage renal disease requiring dialysis. Patients were divided into three groups by their serum total bilirubin concentrations: ≤0.3 (lowest), 0.4-0.5 (middle), and ≥ 0.6 (highest) mg/dL. A Cox proportional hazards model was applied to determine the risk factors for poor renal outcome. Results The median follow-up period was 21 months. One-hundred and three patients reached renal end points. After multivariable adjustment, a 0.1 mg/dL increase in serum bilirubin was associated negatively with poor renal outcome (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.60-0.87). In addition, after adjustment for confounding factors, including traditional and nontraditional cardiovascular risk factors, the middle (HR 3.14, 95% CI 1.36-8.57) and lowest (HR 4.22, 95% CI 1.81-11.59) bilirubin groups had significantly higher HRs for renal outcome than the highest bilirubin group. Conclusions Lower serum bilirubin concentration was independently associated with adverse renal outcomes, suggesting that the measurement of serum bilirubin is useful for predicting kidney disease progression in patients with moderate to severe CKD. ;copy; 2015 Elsevier Inc.

Original languageEnglish
Pages (from-to)1096-1102
Number of pages7
JournalMetabolism: Clinical and Experimental
Volume64
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

Fingerprint

Chronic Renal Insufficiency
Bilirubin
Kidney
Serum
Kidney Diseases
Confidence Intervals
Disease Progression
Diabetic Nephropathies
Proportional Hazards Models
Chronic Kidney Failure
Observational Studies
Dialysis
Creatinine
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease. / Sakoh, Teppei; Nakayama, Masaru; Tanaka, Shigeru; Yoshitomi, Ryota; Ura, Yoriko; Nishimoto, Hitomi; Fukui, Akiko; Shikuwa, Yui; Tsuruya, Kazuhiko; Kitazono, Takanari.

In: Metabolism: Clinical and Experimental, Vol. 64, No. 9, 01.09.2015, p. 1096-1102.

Research output: Contribution to journalArticle

Sakoh, Teppei ; Nakayama, Masaru ; Tanaka, Shigeru ; Yoshitomi, Ryota ; Ura, Yoriko ; Nishimoto, Hitomi ; Fukui, Akiko ; Shikuwa, Yui ; Tsuruya, Kazuhiko ; Kitazono, Takanari. / Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease. In: Metabolism: Clinical and Experimental. 2015 ; Vol. 64, No. 9. pp. 1096-1102.
@article{d7a2dd99eb154f0fb0242a99cfe7a221,
title = "Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease",
abstract = "Objective Serum bilirubin has been reported to be associated with the progression of kidney disease in patients with diabetic nephropathy. Less is known, however, about the relationship between bilirubin and chronic kidney disease (CKD) of other etiologies. This study was designed to clarify whether serum total bilirubin concentration is associated with kidney disease progression in patients with CKD independent of etiology. Materials and methods This prospective observational study enrolled 279 consecutive patients with stages 3-5 CKD. The renal endpoint was the composite of the doubling of serum creatinine or end-stage renal disease requiring dialysis. Patients were divided into three groups by their serum total bilirubin concentrations: ≤0.3 (lowest), 0.4-0.5 (middle), and ≥ 0.6 (highest) mg/dL. A Cox proportional hazards model was applied to determine the risk factors for poor renal outcome. Results The median follow-up period was 21 months. One-hundred and three patients reached renal end points. After multivariable adjustment, a 0.1 mg/dL increase in serum bilirubin was associated negatively with poor renal outcome (hazard ratio [HR], 0.73; 95{\%} confidence interval [CI], 0.60-0.87). In addition, after adjustment for confounding factors, including traditional and nontraditional cardiovascular risk factors, the middle (HR 3.14, 95{\%} CI 1.36-8.57) and lowest (HR 4.22, 95{\%} CI 1.81-11.59) bilirubin groups had significantly higher HRs for renal outcome than the highest bilirubin group. Conclusions Lower serum bilirubin concentration was independently associated with adverse renal outcomes, suggesting that the measurement of serum bilirubin is useful for predicting kidney disease progression in patients with moderate to severe CKD. ;copy; 2015 Elsevier Inc.",
author = "Teppei Sakoh and Masaru Nakayama and Shigeru Tanaka and Ryota Yoshitomi and Yoriko Ura and Hitomi Nishimoto and Akiko Fukui and Yui Shikuwa and Kazuhiko Tsuruya and Takanari Kitazono",
year = "2015",
month = "9",
day = "1",
doi = "10.1016/j.metabol.2015.06.006",
language = "English",
volume = "64",
pages = "1096--1102",
journal = "Metabolism: Clinical and Experimental",
issn = "0026-0495",
publisher = "W.B. Saunders Ltd",
number = "9",

}

TY - JOUR

T1 - Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease

AU - Sakoh, Teppei

AU - Nakayama, Masaru

AU - Tanaka, Shigeru

AU - Yoshitomi, Ryota

AU - Ura, Yoriko

AU - Nishimoto, Hitomi

AU - Fukui, Akiko

AU - Shikuwa, Yui

AU - Tsuruya, Kazuhiko

AU - Kitazono, Takanari

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Objective Serum bilirubin has been reported to be associated with the progression of kidney disease in patients with diabetic nephropathy. Less is known, however, about the relationship between bilirubin and chronic kidney disease (CKD) of other etiologies. This study was designed to clarify whether serum total bilirubin concentration is associated with kidney disease progression in patients with CKD independent of etiology. Materials and methods This prospective observational study enrolled 279 consecutive patients with stages 3-5 CKD. The renal endpoint was the composite of the doubling of serum creatinine or end-stage renal disease requiring dialysis. Patients were divided into three groups by their serum total bilirubin concentrations: ≤0.3 (lowest), 0.4-0.5 (middle), and ≥ 0.6 (highest) mg/dL. A Cox proportional hazards model was applied to determine the risk factors for poor renal outcome. Results The median follow-up period was 21 months. One-hundred and three patients reached renal end points. After multivariable adjustment, a 0.1 mg/dL increase in serum bilirubin was associated negatively with poor renal outcome (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.60-0.87). In addition, after adjustment for confounding factors, including traditional and nontraditional cardiovascular risk factors, the middle (HR 3.14, 95% CI 1.36-8.57) and lowest (HR 4.22, 95% CI 1.81-11.59) bilirubin groups had significantly higher HRs for renal outcome than the highest bilirubin group. Conclusions Lower serum bilirubin concentration was independently associated with adverse renal outcomes, suggesting that the measurement of serum bilirubin is useful for predicting kidney disease progression in patients with moderate to severe CKD. ;copy; 2015 Elsevier Inc.

AB - Objective Serum bilirubin has been reported to be associated with the progression of kidney disease in patients with diabetic nephropathy. Less is known, however, about the relationship between bilirubin and chronic kidney disease (CKD) of other etiologies. This study was designed to clarify whether serum total bilirubin concentration is associated with kidney disease progression in patients with CKD independent of etiology. Materials and methods This prospective observational study enrolled 279 consecutive patients with stages 3-5 CKD. The renal endpoint was the composite of the doubling of serum creatinine or end-stage renal disease requiring dialysis. Patients were divided into three groups by their serum total bilirubin concentrations: ≤0.3 (lowest), 0.4-0.5 (middle), and ≥ 0.6 (highest) mg/dL. A Cox proportional hazards model was applied to determine the risk factors for poor renal outcome. Results The median follow-up period was 21 months. One-hundred and three patients reached renal end points. After multivariable adjustment, a 0.1 mg/dL increase in serum bilirubin was associated negatively with poor renal outcome (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.60-0.87). In addition, after adjustment for confounding factors, including traditional and nontraditional cardiovascular risk factors, the middle (HR 3.14, 95% CI 1.36-8.57) and lowest (HR 4.22, 95% CI 1.81-11.59) bilirubin groups had significantly higher HRs for renal outcome than the highest bilirubin group. Conclusions Lower serum bilirubin concentration was independently associated with adverse renal outcomes, suggesting that the measurement of serum bilirubin is useful for predicting kidney disease progression in patients with moderate to severe CKD. ;copy; 2015 Elsevier Inc.

UR - http://www.scopus.com/inward/record.url?scp=84939562298&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939562298&partnerID=8YFLogxK

U2 - 10.1016/j.metabol.2015.06.006

DO - 10.1016/j.metabol.2015.06.006

M3 - Article

C2 - 26142826

AN - SCOPUS:84939562298

VL - 64

SP - 1096

EP - 1102

JO - Metabolism: Clinical and Experimental

JF - Metabolism: Clinical and Experimental

SN - 0026-0495

IS - 9

ER -