Association between Serum Bilirubin and Estimated Glomerular Filtration Rate among Diabetic Patients

Abstract

The subjects comprised 230 men aged 77 ± 10 (range: 50–100) years and 279 women aged 81 ± 10 (50–101) years that visited the medical department. We examined the relationship between increased serum bilirubin and renal function evaluated by estimated glomerular filtration rate (eGFR) using CKD-EPI equations modified by a Japanese coefficient. Compared with the fourth quartile in serum bilirubin (1.01–1.97 mg/dL), the nonadjusted, age and gender-adjusted, and multivariate-adjusted odds ratios {95% confidence interval (CI)} of eGFR <60 mL/min/1.73 m2 for the first quartile in serum bilirubin (0.13–0.50 mg/dL) were 2.08 (1.25–3.44), 1.82 (1.07–3.09), and 1.53 (0.83–2.81), respectively. Moreover, compared with the fourth quartile, nonadjusted, age and gender-adjusted, and multivariate-adjusted odds ratios (95% CI) of eGFR <45 mL/min/1.73 m2 for the first quartile were 3.50 (1.95–6.23), 3.12 (1.72–5.65), and 3.53 (1.71–7.26), respectively. The data were further stratified by gender, age, medication (antihypertensive, antidyslipidemic, and antidiabetic agents), and prevalence of cardiovascular disease (CVD). The standardized coefficients for eGFR were significant in all the subgroups other than the prevalence of CVD, and there were significant interactions between the two groups regarding CVD. Our data demonstrated an independent positive association between serum bilirubin and eGFR among diabetic patients.

Association of Serum Total Bilirubin and Uric Acid with Low Glomerular Filtration Rate Diabetic Kidney Disease in Type 2 Diabetic Patients

“…Patients having lower serum total bilirubin were found to be 2.23-times more likely to develop diabetic kidney disease than patients with a high serum total bilirubin level. This is supported by the findings of Takeaki et al 19 …”

“…Patients having lower serum total bilirubin were found to be 2.23-times more likely to develop diabetic kidney disease than patients with a high serum total bilirubin level. This is supported by the findings of Takeaki et al 19 Uric acid (UA) is the end product of purine metabolism in humans, and its high serum levels (hyperuricemia) are classically related to the precipitation of crystals in the joints, leading to arthritis. 20 In our study it was observed that there is a significant mean value difference (p<0.001) and the serum uric acid level was observed to be higher in patients with diabetic nephropathy.…”

Association of Serum Bilirubin Levels with Macro- and Microvascular Complications in Chinese People with Type 2 Diabetes Mellitus: New Insight on Gender Differences

“…Japanese diabetic patients reported a positive association between serum bilirubin and eGFR. 23 Our findings were consistent with previous study, which imply an important protective effects of bilirubin on the progression of diabetic nephropathy.…”

Association between serum bilirubin levels and progression of albuminuria in Taiwanese with type 2 diabetes mellitus

“…The renal protective effect of BIL has recently attracted much attention. Higher serum BIL within the normal range is associated with less ABU and less deterioration in glomerular function in both type 1 and type 2 diabetic patients [ [11] , [12] , [13] , [14] , [18] , [19] , [20] ]. Because most of the relevant studies have been reported in Japanese populations, a large-scale single-center database cohort study from Taiwan was conducted to evaluate a possible ethnic difference in results and to assess the relationship between serum BIL and AUPr in type 2 diabetes.…”