Relationship of serum bilirubin concentrations to kidney function and albuminuria in the United States adult population. Findings from the National Health and Nutrition Examination Survey 2001–2006

Targher, Giovanni; Bosworth, Cortney; Kendrick, Jessica; Smits, Gerard; Lippi, Giuseppe; Chonchol, Michel

doi:10.1515/cclm.2009.244

Cited by 43 publications

(40 citation statements)

References 34 publications

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“…These findings confirm and extend a recent work by Yilmaz et al (20), showing that microalbuminuria is independently associated with the histologic features of NAFLD (i.e., fibrosis stage) in a selected sample of nondiabetic patients with biopsyproven NAFLD; however, in this study, both patients with simple steatosis and those with borderline or definitive NASH were included and, more importantly, a control group was lacking (20). Our findings are also corroborated by recent large observational studies showing that the presence of NAFLD as detected by either serum liver enzymes (6,7,11,12) or liver ultrasound (8 -10,13,14) (and should therefore be interpreted with caution) is strongly associated with an increased prevalence and incidence of CKD in both nondiabetic and diabetic individuals.…”

Section: Discussionsupporting

confidence: 83%

Relationship between Kidney Function and Liver Histology in Subjects with Nonalcoholic Steatohepatitis

Targher

Bertolini²,

Rodella³

et al. 2010

Clinical Journal of the American Society of Nephrology

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214

161

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Background and objectives:We assessed whether nonalcoholic steatohepatitis (NASH) diagnosed by liver biopsy is associated with decreased kidney function and whether such association is independent of insulin resistance and features of the metabolic syndrome.Design, settings, participants, & measurements: We enrolled 80 consecutive overweight patients with biopsy-proven NASH and 80 nonsteatotic control subjects who were matched for age, gender, and body mass index. Chronic kidney disease (CKD) was defined as the presence of estimated GFR (eGFR) of <60 ml/min per 1.73 m 2 and/or abnormal albuminuria (i.e., urinary albumin/creatinine ratio >30 mg/g).Results: NASH patients had significantly (P < 0.001) lower eGFR (75.3 ؎ 12 versus 87.5 ؎ 6 ml/min per 1.73 m 2 ) and a greater frequency of abnormal albuminuria (14 versus 2.5%) and CKD (25 versus 3.7%) than control subjects. The significant differences in eGFR, albuminuria, and CKD that were observed between the two groups were only slightly weakened after adjustment for age, gender, body mass index, smoking status, insulin resistance (by homeostasis model assessment), and components of the metabolic syndrome. Notably, histologic severity of NASH (i.e., fibrosis stage) was strongly associated with either decreasing eGFR or increasing albuminuria (P < 0.01 or less), independently of potential confounding factors.Conclusions: Our findings suggest that patients with biopsy-proven NASH have moderately decreased eGFR and a higher frequency of abnormal albuminuria and CKD than matched control subjects and that the severity of NASH histology is associated with decreased kidney function, independently of traditional risk factors, insulin resistance, and components of the metabolic syndrome.

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Section: Discussionsupporting

confidence: 83%

Relationship between Kidney Function and Liver Histology in Subjects with Nonalcoholic Steatohepatitis

Targher

Bertolini²,

Rodella³

et al. 2010

Clinical Journal of the American Society of Nephrology

Self Cite

214

161

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show abstract

“…These findings are in accordance with recent work by Targher et al [6] which showed that patients with biopsy proven NASH have a moderately decreased eGFR and that the severity of NASH histology is associated with decreased kidney function. Our results are also corroborated by recent observational studies which showed that the presence of NAFLD is strongly associated with an increased prevalence of CKD [7,11,12]. Furthermore, Yilmaz et al [13] showed a positive correlation between microalbuminuria and liver fibrosis in nondiabetic patients with NAFLD.…”

Section: Disscusionsupporting

confidence: 91%

Chronic Kidney Disease and Nonalcoholic Fatty Liver Disease Proven by Transient Elastography

Mikolašević

Rački

Bubić

et al. 2013

Kidney Blood Press Res

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Background/Aim: Preliminary data suggest an association between chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD). The aim of this study was to further investigate the association between NAFLD and decreased kidney function. Methods: A total of 62 patients with CKD were enrolled in the study. Liver stiffness was used to detect liver fibrosis and CAP (controlled attenuation parameter) was used to detect and quantify liver steatosis (Fibroscan®). NAFLD was defined by CAP values ≥238 dB.m^-1. Results: CKD stage III was present in 29 patients (46.8%) and CKD stage IV in 33 patients (53.2%). Out of 62 CKD patients 53 (85.5%) had NAFLD and of these 14/53 patients (26.4%) had also liver stiffness >7 kPa. The severity of liver steatosis was positively correlated with serum creatinine (r=0.399;p<0.01) and CRP (r=0.261; p<0.05) and negatively correlated with eGFR (r=-0.413; p<0.01) and serum iron concentration (r=-0.365; p<0.01). Conclusion: The results suggest a high prevalence of NAFLD in CKD patients. The severity of liver steatosis is negatively correlated with kidney function. The study documents the value of ultrasonographic elastography as an effective non-invasive screening method for the diagnosis of NAFLD.

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“…Fukui et al demonstrated a positive correlation between the TBIL concentration and the estimated GFR in Japanese diabetic patients, and suggested that TBIL may play a role in diabetic nephropathy 33) . Meanwhile, in a US adult population, increasing levels of TBIL were independently associated with decreasing estimated GFR and increasing albuminuria 34) . Thus, bilirubin levels are not likely to have significant effects in all subjects as their effects may depend on the presence of diabetes mellitus or the cause and stage of CKD, and our results partly support this hypothesis.…”

Section: Discussionmentioning

confidence: 94%

Serum Levels of Bilirubin as an Independent Predictor of Coronary In-Stent Restenosis: A New Look at an Old Molecule

Kuwano

Miura

Shirai³

et al. 2011

JAT

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Aim: In-stent restenosis (ISR) remains the major limitation of percutaneous coronary intervention (PCI), and the mechanism of ISR is neointimal growth. Higher serum total bilirubin (TBIL) inhibits the inflammatory response and the proliferation of vascular smooth muscle cells; however, the relationship between TBIL and ISR is still unclear. This study aimed to determine whether the serum bilirubin level is associated with ISR after coronary stenting in patients with coronary artery disease. Methods: This study investigated 1076 consecutive patients who underwent coronary stenting and follow-up angiography (average period: 236 days) using the Fukuoka University Hospital Registry. We used multivariate logistic regression analysis to identify independent predictors of ISR.

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Relationship of serum bilirubin concentrations to kidney function and albuminuria in the United States adult population. Findings from the National Health and Nutrition Examination Survey 2001–2006

Cited by 43 publications

References 34 publications

Relationship between Kidney Function and Liver Histology in Subjects with Nonalcoholic Steatohepatitis

Relationship between Kidney Function and Liver Histology in Subjects with Nonalcoholic Steatohepatitis

Chronic Kidney Disease and Nonalcoholic Fatty Liver Disease Proven by Transient Elastography

Serum Levels of Bilirubin as an Independent Predictor of Coronary In-Stent Restenosis: A New Look at an Old Molecule

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