Chronic kidney disease is one of the most serious public health burdens globally, with significant morbidity, mortality, and reduced in patient life expectancy. Although the current marker of kidney disease is the glomerular filtration rate (GFR), the serum creatinine used for GFR determination is influenced by many factors. Therefore, it has become increasingly important to search for possible additional parameters related to estimated glomerular filtration rate to enhance early detection of disease progression. A hospital-based cross-sectional study was conducted at Jimma University Medical Center to evaluate serum bilirubin parameter and its correlation with eGFR in the chronic kidney disease patients on follow-up. Using consecutive sampling technique, a total of 140 CKD follow-up patients were recruited into the current study. Then, data were collected using interviewer-based structured questionnaires, record reviews, and physical examinations. Data were analyzed by SPSS version 25.0. The correlation between eGFR as well as other explanatory variables with serum bilirubin (total and direct) concentrations was examined by Pearson’s correlation analyses. Univariate and multivariate linear regression were used to test predictors of serum bilirubin (total and direct bilirubin). Subjects of this study included (54.3% [n = 76]) men and (45.7% [n = 64]) women, respectively. The mean (SD) age of study subjects was 51.04±9.02 years with a minimum and maximum age of being 30 and 70 years old, respectively. A positive correlation was found between serum bilirubin and eGFR; total bilirubin (r = 0.868, P < 0.001), direct bilirubin (r = 0.641, P < 0.001). BMI was negatively correlated (r = -0.221, P < 0.009) with serum bilirubin value. Moreover, the eGFR value was positively associated (β = 0.04, P =< 0.001) with serum total bilirubin among study participants. As a conclusion, estimated glomerular filtration rate were positively correlated with both serum total and direct bilirubin. Furthermore, eGFR was positively associated with serum total and direct bilirubin in the study subjects, whereas BMI was negatively associated with serum bilirubin in CKD participants. Therefore, low serum bilirubin (total and direct bilirubin) and increased body mass index are independent risk factors for disease progression in patients with CKD.
Published in | Science Journal of Clinical Medicine (Volume 11, Issue 4) |
DOI | 10.11648/j.sjcm.20221104.12 |
Page(s) | 77-84 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Total Bilirubin, Direct Serum Bilirubin, Chronic Kidney Disease, eGFR
[1] | Shiferaw WS, Akalu TY, Aynalem YA. Chronic Kidney Disease among Diabetes Patients in Ethiopia: A Systematic Review and Meta-Analysis. Int J Nephrol. 2020. |
[2] | Levey AS, Atkins R, Coresh J, Cohen EP, Collins AJ, Eckardt KU, et al. Chronic kidney disease as a global public health problem: Approaches and initiatives - A position statement from Kidney Disease Improving Global Outcomes. Kidney Int. 2007; 72 (3): 247–59. |
[3] | Nugent RA, Fathima F, Feigl AB. The Burden of Chronic Kidney Disease on Developing Nations : A 21st Century. 2011; 20036: 269–77. |
[4] | Niang A, Lemrabott AT. Global Dialysis Perspective: Senegal. Kidney360. 2020; 1 (6): 538–40. |
[5] | Tomaiuolo G. Biomechanical properties of red blood cells in health and disease. Biomicrofluidics. 2014; 8 (5): 1–19. |
[6] | Alemu H, Hailu W, Adane A. Prevalence of Chronic Kidney Disease and Associated Factors among Patients with Diabetes in Northwest Ethiopia , 2020; 92: 100578. |
[7] | Abdulkadr M. Epidemiology of Chronic Kidney Diseases in Ethiopian Police Hospital : Institutional based cross sectional study. 2019; 1–14. |
[8] | Duni A, Liakopoulos V, Rapsomanikis K, Dounousi E. Review Article Chronic Kidney Disease and Disproportionally Increased Cardiovascular Damage; 2017. |
[9] | Boon A, Bulmer AC, Coombes JS, Fassett RG. Novel Therapeutics in Renal Diseases Circulating bilirubin and defense against kidney disease and cardiovascular mortality : mechanisms contributing to protection in clinical investigations. 2014; 2. |
[10] | Jha JC, Ho F, Dan C, Jandeleit-dahm K. A causal link between oxidative stress and inflammation in cardiovascular and renal complications of diabetes. 2018: 1811–36. |
[11] | Richard Kitching A, Hutton HL. The players: Cells involved in glomerular disease. Clin J Am Soc Nephrol. 2016; 11 (9): 1664–74. |
[12] | Lambert MP. Platelets in liver and renal disease. Hematology. 2016; 2016 (1): 251–5. |
[13] | Chávez-iñiguez JS, Meza-ríos A, Santos-garcia A, García-garcía G, Armendariz-borunda J. Cholemic Nephropathy : Hyperbilirubinemia and its Impact on Renal Function. 2019; 3 (5): 33–9. |
[14] | Sticova E, Jirsa M. New insights in bilirubin metabolism and their clinical implications. World J Gastroenterol. 2013; 19 (38): 6398–407. |
[15] | Farasat T, Sharif S, Manzoor F, Naz S. Serum bilirubin is significantly associated with Hba1c in type 2 diabetic subjects. 2017; 5 (6): 338–41. |
[16] | Ratliff BB, Abdulmahdi W, Pawar R, Wolin MS. Oxidant mechanisms in renal injury and disease. Antioxidants Redox Signal. 2016; 25 (3): 119–46. |
[17] | Sundararaghavan VL, Binepal S, Stec DE, Sindhwani P, Hinds TD. AC US. Rena; transplant. 2018. 06. 003. |
[18] | Nishimura T, Tanaka M, Sekioka R, Itoh H. Serum bilirubin concentration is associated with eGFR and urinary albumin excretion in patients with type 1 diabetes mellitus. Journal of Diabetes and Its Complications; 2015. 07. 007. |
[19] | Moolchandani K, Priyadarssini M, Rajappa M, Parameswaran S. Serum bilirubin : a simple routine surrogate marker of the progression of chronic kidney disease. 2016; 48. 45. |
[20] | Shin HS, Jung YS, Rim H. Relationship of serum bilirubin concentration to kidney function and 24-hour urine protein in Korean adults. 2011. |
[21] | Uludag K, Oguzhan N, Arıkan T, and GB-I. Serum bilirubin level and its impact on the progression of chronic kidney disease. Springer, 2021-018-1923-9. |
[22] | Li J, Liu D, medicine ZL-F. Serum Total Bilirubin and Progression of Chronic Kidney Disease and Mortality: A Systematic Review and Meta-Analysis, 2020. |
[23] | Park S, Kim DH, Hwang JH, Kim Y, Kim JH, Lim S, et al. Elevated bilirubin levels are associated with a better renal prognosis and ameliorate kidney fibrosis. 2017; 1–16. |
[24] | Lee J, Kim EJ, Lee JG, Kim BS, Huh KH, Kim MS, et al. Clinical impact of serum bilirubin levels on kidney transplant outcomes. Sci Rep. 2021; (0123456789): 1–10. |
[25] | Boon A, Lam AK, Gopalan V, Benzie IF, Briskey D, Coombes JS, et al. Endogenously elevated bilirubin modulates kidney function and protects from circulating oxidative stress in a rat model of adenine- induced kidney failure. Nat Publ Gr. 2015; (September): 1–16. |
[26] | U. S. Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States | Michigan Medicine us-renal-data-system-2019. |
[27] | Hall V, Thomsen RW, Henriksen O, Lohse N. Diabetes in Sub Saharan Africa 1999-2011 : Epidemiology and public health implications. a systematic review. 2011. |
[28] | Delanaye P, Cavalier E, Pottel H. Serum Creatinine: Nephron 2017; 136 (4): 302–8. |
[29] | Study S, Jigjiga AT, Hospital KG. Estimation of serum high sensitivity c-reactive protein. in pregnancy induced hypertensive, 2018. |
[30] | Han SS, Na KY, Chae D, Kim YS, Kim S, Chin HJ. High Serum Bilirubin Is Associated with the Reduced Risk of Diabetes Mellitus and Diabetic Nephropathy. 2010; 133–40. |
[31] | Ammirati AL. Chronic Kidney Disease. 2020; 66; 11. |
[32] | Kawamoto R, Ninomiya D, Hasegawa Y, Kasai Y, Kusunoki T, Ohtsuka N, et al. Association between serum bilirubin and estimated glomerular filtration rate among elderly persons. PLoS One. 2014; 9 (12): 1–11. |
[33] | Henery minor sources of bilirubin in serum bilirubin metabolism. 2018. |
[34] | Sakoh T, Nakayama M, Tanaka S, Yoshitomi R, Ura Y, Nishimoto H, et al. Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease. Metabolism. 2015; 64 (9): 1096–102. |
[35] | Nascimento H, Kohlova M, Bronze-da-rocha E, Mansilha HF, Rocha-pereira P, Santos-silva A, et al. Body Fat Percentage Is a Major Determinant of Total Bilirubin Independently of UGT1A1 * 28 Polymorphism in Young Obese. 2014; 9 (6). |
[36] | Petelin A, Jurdana M, Pražnikar ZJ, Žiberna L. Serum bilirubin correlates with serum adipokines in normal weight. 2020: 19–29. |
[37] | Bellarosa C, Bedogni G, Bianco A, Cicolini S, Caroli D, Tiribelli C, et al. Association of Serum Bilirubin Level with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease in Obese Children. 2021. |
[38] | Zhang F, Guan W, Fu Z, Zhou L, Guo W, Ma Y, et al. Relationship between Serum Indirect Bilirubin Level and Insulin Sensitivity : Results from Two Independent Cohorts of Obese Patients with Impaired Glucose Regulation and Type 2 Diabetes Mellitus in China. 2020. |
[39] | Targher G, Bosworth C, Kendrick J, Smits G, Chonchol M. 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. 2009; 47 (9): 1055–62. |
APA Style
Fikadu Seyoum Tola, Belay Zewdie Wondimu. (2022). Serum Bilirubin Association with Estimated Glomerular Filtration Rate and Other Risk Factors Among Chronic Kidney Disease Patients. Science Journal of Clinical Medicine, 11(4), 77-84. https://doi.org/10.11648/j.sjcm.20221104.12
ACS Style
Fikadu Seyoum Tola; Belay Zewdie Wondimu. Serum Bilirubin Association with Estimated Glomerular Filtration Rate and Other Risk Factors Among Chronic Kidney Disease Patients. Sci. J. Clin. Med. 2022, 11(4), 77-84. doi: 10.11648/j.sjcm.20221104.12
@article{10.11648/j.sjcm.20221104.12, author = {Fikadu Seyoum Tola and Belay Zewdie Wondimu}, title = {Serum Bilirubin Association with Estimated Glomerular Filtration Rate and Other Risk Factors Among Chronic Kidney Disease Patients}, journal = {Science Journal of Clinical Medicine}, volume = {11}, number = {4}, pages = {77-84}, doi = {10.11648/j.sjcm.20221104.12}, url = {https://doi.org/10.11648/j.sjcm.20221104.12}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20221104.12}, abstract = {Chronic kidney disease is one of the most serious public health burdens globally, with significant morbidity, mortality, and reduced in patient life expectancy. Although the current marker of kidney disease is the glomerular filtration rate (GFR), the serum creatinine used for GFR determination is influenced by many factors. Therefore, it has become increasingly important to search for possible additional parameters related to estimated glomerular filtration rate to enhance early detection of disease progression. A hospital-based cross-sectional study was conducted at Jimma University Medical Center to evaluate serum bilirubin parameter and its correlation with eGFR in the chronic kidney disease patients on follow-up. Using consecutive sampling technique, a total of 140 CKD follow-up patients were recruited into the current study. Then, data were collected using interviewer-based structured questionnaires, record reviews, and physical examinations. Data were analyzed by SPSS version 25.0. The correlation between eGFR as well as other explanatory variables with serum bilirubin (total and direct) concentrations was examined by Pearson’s correlation analyses. Univariate and multivariate linear regression were used to test predictors of serum bilirubin (total and direct bilirubin). Subjects of this study included (54.3% [n = 76]) men and (45.7% [n = 64]) women, respectively. The mean (SD) age of study subjects was 51.04±9.02 years with a minimum and maximum age of being 30 and 70 years old, respectively. A positive correlation was found between serum bilirubin and eGFR; total bilirubin (r = 0.868, P < 0.001), direct bilirubin (r = 0.641, P < 0.001). BMI was negatively correlated (r = -0.221, P < 0.009) with serum bilirubin value. Moreover, the eGFR value was positively associated (β = 0.04, P =< 0.001) with serum total bilirubin among study participants. As a conclusion, estimated glomerular filtration rate were positively correlated with both serum total and direct bilirubin. Furthermore, eGFR was positively associated with serum total and direct bilirubin in the study subjects, whereas BMI was negatively associated with serum bilirubin in CKD participants. Therefore, low serum bilirubin (total and direct bilirubin) and increased body mass index are independent risk factors for disease progression in patients with CKD.}, year = {2022} }
TY - JOUR T1 - Serum Bilirubin Association with Estimated Glomerular Filtration Rate and Other Risk Factors Among Chronic Kidney Disease Patients AU - Fikadu Seyoum Tola AU - Belay Zewdie Wondimu Y1 - 2022/11/29 PY - 2022 N1 - https://doi.org/10.11648/j.sjcm.20221104.12 DO - 10.11648/j.sjcm.20221104.12 T2 - Science Journal of Clinical Medicine JF - Science Journal of Clinical Medicine JO - Science Journal of Clinical Medicine SP - 77 EP - 84 PB - Science Publishing Group SN - 2327-2732 UR - https://doi.org/10.11648/j.sjcm.20221104.12 AB - Chronic kidney disease is one of the most serious public health burdens globally, with significant morbidity, mortality, and reduced in patient life expectancy. Although the current marker of kidney disease is the glomerular filtration rate (GFR), the serum creatinine used for GFR determination is influenced by many factors. Therefore, it has become increasingly important to search for possible additional parameters related to estimated glomerular filtration rate to enhance early detection of disease progression. A hospital-based cross-sectional study was conducted at Jimma University Medical Center to evaluate serum bilirubin parameter and its correlation with eGFR in the chronic kidney disease patients on follow-up. Using consecutive sampling technique, a total of 140 CKD follow-up patients were recruited into the current study. Then, data were collected using interviewer-based structured questionnaires, record reviews, and physical examinations. Data were analyzed by SPSS version 25.0. The correlation between eGFR as well as other explanatory variables with serum bilirubin (total and direct) concentrations was examined by Pearson’s correlation analyses. Univariate and multivariate linear regression were used to test predictors of serum bilirubin (total and direct bilirubin). Subjects of this study included (54.3% [n = 76]) men and (45.7% [n = 64]) women, respectively. The mean (SD) age of study subjects was 51.04±9.02 years with a minimum and maximum age of being 30 and 70 years old, respectively. A positive correlation was found between serum bilirubin and eGFR; total bilirubin (r = 0.868, P < 0.001), direct bilirubin (r = 0.641, P < 0.001). BMI was negatively correlated (r = -0.221, P < 0.009) with serum bilirubin value. Moreover, the eGFR value was positively associated (β = 0.04, P =< 0.001) with serum total bilirubin among study participants. As a conclusion, estimated glomerular filtration rate were positively correlated with both serum total and direct bilirubin. Furthermore, eGFR was positively associated with serum total and direct bilirubin in the study subjects, whereas BMI was negatively associated with serum bilirubin in CKD participants. Therefore, low serum bilirubin (total and direct bilirubin) and increased body mass index are independent risk factors for disease progression in patients with CKD. VL - 11 IS - 4 ER -