The Mildly Elevated Serum Bilirubin Level is Negatively Associated with the Incidence of End Stage Renal Disease in Patients with IgA Nephropathy.
10.3346/jkms.2009.24.S1.S22
- Author:
Ho Jun CHIN
1
;
Hyun Jin CHO
;
Tae Woo LEE
;
Ki Young NA
;
Kook Hwan OH
;
Kwon Wook JOO
;
Hyung Jin YOON
;
Yon Su KIM
;
Curie AHN
;
Jin Suk HAN
;
Suhnggwon KIM
;
En Sil JEON
;
Dong Chan JIN
;
Yong Lim KIM
;
Sun Hee PARK
;
Chan Duck KIM
;
Young Rim SONG
;
Seong Gyun KIM
;
Yoon Goo KIM
;
Jung Eun LEE
;
Yoon Kyu OH
;
Chun Soo LIM
;
Sang Koo LEE
;
Dong Wan CHAE
;
Won Yong CHO
;
Hyoung Kyu KIM
;
Sang Kyung JO
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. mednep@snubh.org
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Bilirubin;
Glomerulonephritis, IGA;
Kidney Failure, Chronic
- MeSH:
Adult;
Bilirubin/*blood;
Disease Progression;
Female;
Glomerular Filtration Rate;
Glomerulonephritis, IGA/*blood/complications;
Humans;
Hypertension/complications;
Incidence;
Kidney Failure, Chronic/*blood/complications;
Male;
Middle Aged;
Risk;
Risk Factors;
Treatment Outcome
- From:Journal of Korean Medical Science
2009;24(Suppl 1):S22-S29
- CountryRepublic of Korea
- Language:English
-
Abstract:
Oxidative stress plays various roles in the development and progression of IgA nephropathy, while bilirubin is known as a potent antioxidant. We therefore hypothesized that serum bilirubin would be associated with renal prognosis in IgA nephropathy. The study subjects comprised 1,458 adult patients with primary IgA nephropathy in Korea. We grouped patients according to the following quartile levels of bilirubin: <0.4 mg/dL (Q1), 0.4-0.5 mg/dL (Q2), 0.6-0.7 mg/dL (Q3), and >0.8 mg/dL (Q4). The outcome data were obtained from the Korean Registry of end-stage renal disease (ESRD). Eighty patients (5.5%) contracted ESRD during a mean follow-up period of 44.9 months. The ESRD incidences were 10.7% in Q1, 8.2% in Q2, 2.8% in Q3, and 2.8% in Q4 (p<0.001). The relative risk of ESRD compared to that in Q1 was 0.307 (95% confidence interval [CI], 0.126-0.751) in Q3 and 0.315 (95% CI, 0.130-0.765) in Q4. The differences of ESRD incidence were greater in subgroups of males and of patients aged 35 yr or more, with serum albumin 4.0 g/dL or more, with normotension, with eGFR 60 mL/min/1.73 m2 or more, and with proteinuria less then 3+ by dipstick test. In conclusion, higher bilirubin level was negatively associated with ESRD incidence in IgA nephropathy.
