The mildly elevated serum bilirubin level is negatively associated with the incidence of end stage renal disease in patients with IgA nephropathy.
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.
Chin
Ho Jun
HJ
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Cho
Hyun Jin
HJ
Lee
Tae Woo
TW
Na
Ki Young
KY
Oh
Kook Hwan
KH
Joo
Kwon Wook
KW
Yoon
Hyung Jin
HJ
Kim
Yon-Su
YS
Ahn
Curie
C
Han
Jin Suk
JS
Kim
Suhnggwon
S
Jeon
En Sil
ES
Jin
Dong Chan
DC
Kim
Yong-Lim
YL
Park
Sun-Hee
SH
Kim
Chan-Duck
CD
Song
Young Rim
YR
Kim
Seong Gyun
SG
Kim
Yoon Goo
YG
Lee
Jung Eun
JE
Oh
Yoon Kyu
YK
Lim
Chun Soo
CS
Lee
Sang Koo
SK
Chae
Dong-Wan
DW
Cho
Won Yong
WY
Kim
Hyoung Kyu
HK
Jo
Sang-Kyung
SK
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
D001663:Bilirubin