title: The mildly elevated serum bilirubin level is negatively associated with the incidence of end stage renal disease in patients with IgA nephropathy.
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 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.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Chin
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Cho
authors.forename: Tae Woo
authors.initials: TW
authors.lastname: Lee
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Na
authors.forename: Kook Hwan
authors.initials: KH
authors.lastname: Oh
authors.forename: Kwon Wook
authors.initials: KW
authors.lastname: Joo
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Yon-Su
authors.initials: YS
authors.lastname: Kim
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
authors.forename: Jin Suk
authors.initials: JS
authors.lastname: Han
authors.forename: Suhnggwon
authors.initials: S
authors.lastname: Kim
authors.forename: En Sil
authors.initials: ES
authors.lastname: Jeon
authors.forename: Dong Chan
authors.initials: DC
authors.lastname: Jin
authors.forename: Yong-Lim
authors.initials: YL
authors.lastname: Kim
authors.forename: Sun-Hee
authors.initials: SH
authors.lastname: Park
authors.forename: Chan-Duck
authors.initials: CD
authors.lastname: Kim
authors.forename: Young Rim
authors.initials: YR
authors.lastname: Song
authors.forename: Seong Gyun
authors.initials: SG
authors.lastname: Kim
authors.forename: Yoon Goo
authors.initials: YG
authors.lastname: Kim
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Yoon Kyu
authors.initials: YK
authors.lastname: Oh
authors.forename: Chun Soo
authors.initials: CS
authors.lastname: Lim
authors.forename: Sang Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Chae
authors.forename: Won Yong
authors.initials: WY
authors.lastname: Cho
authors.forename: Hyoung Kyu
authors.initials: HK
authors.lastname: Kim
authors.forename: Sang-Kyung
authors.initials: SK
authors.lastname: Jo
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000097:blood* / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001663:Bilirubin