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The Mildly Elevated Serum Bilirubin Level is Negatively Associated with the Incidence of End Stage Renal Disease in Patients with IgA Nephropathyopen access

Authors
Chin, Ho JunCho, Hyun JinLee, Tae WooNa, Ki YoungOh, Kook HwanJoo, Kwon WookYoon, Hyung JinKim, Yon-SuAhn, CurieHan, Jin SukKim, SuhnggwonJeon, En SilJin, Dong ChanKim, Yong-LimPark, Sun-HeeKim, Chan-DuckSong, Young RimKim, Seong GyunKim, Yoon GooLee, Jung EunOh, Yoon KyuLim, Chun SooLee, Sang KooChae, Dong-WanCho, Won YongKim, Hyoung KyuJo, Sang-Kyung
Issue Date
Jan-2009
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Bilirubin; Glomerulonephritis, IGA; Kidney Failure, Chronic
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.24, pp.S22 - S29
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
24
Start Page
S22
End Page
S29
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/16308
DOI
10.3346/jkms.2009.24.S1.S22
ISSN
1011-8934
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 04 (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 m(2) 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.
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Anam Hospital (Department of Nephrology and Hypertension, Anam Hospital)
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