title: Hypobilirubinemia might be a possible risk factor of end-stage kidney disease independently of estimated glomerular filtration rate.
abstract: OBJECTIVE
  The relationship between serum total bilirubin (TB) and estimated glomerular filtration rate (eGFR) is controversial and there is no report on the association between TB and end-stage kidney disease (ESKD).
  
  
  METHODS
  We examined the cross-sectional association between TB and eGFR and investigated whether TB can predict ESKD with multivariable logistic regression adjusted for age, sex, and baseline eGFR using hospital-based data.
  
  
  RESULTS
  The geometric mean TB of patients with eGFR ≥ 90 mL/min/1.73 m2 (S1), 8960 mL/min/1.73 m2 (S2), 59-30 mL/min/1.73 m2 (S3), 29-15 mL/min/1.73 m2 (S4), and < 15 mL/min/1.73 m2 (S5 = ESKD) was 0.55 mg/dL, 0.59 mg/dL, 0.56 mg/dL, 0.47 mg/dL, and 0.36 mg/dL (all p<0.0001 except for S1 vs. S3 where p=0.3726), respectively excluding patients with hyperbilirubinemia (TB > 1.24 mg/dL). The odds ratio (95% confidence interval) of incident ESKD for each 0.1 mg/dL increase in TB and hypobilirubinemia defined as TB ≤ 0.34 mg/dL were 0.92 (0.80-1.07) (p=0.2804) and 3.51 (1.56-7.88) (p=0.0023), respectively in patients with baseline eGFR ≥ 15 mL/min/1.73 m2 and 0.59 (0.37-0.95) (p=0.0283) and 6.03 (1.63-22.30) (p=0.0071), respectively in patients with baseline eGFR 29-15 mL/min/1.73 m2.
  
  
  CONCLUSIONS
  Hypobilirubinemia might be a possible risk factor of ESKD.
authors: Tachikawa Medical Check-up Center, Tachikawa Medical Center, Nagaoka, Japan. ijie@venus.sannet.ne.jp
authors: Eiji
authors: E
authors: Oda
authors: Ryuzi
authors: R
authors: Aoyagi
authors: Yoshifusa
authors: Y
authors: Aizawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001663:Bilirubin