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Association between bilirubin and chronic kidney disease in hypertensive patients: The China hypertension registry
Peixu Zhao1,2,3, Haitao Xu4, Yumeng Shi1,2,3
1Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Insights
Higher levels of Direct bilirubin (DBIL) and Indirect bilirubin (IBIL) are linked to a lower risk of chronic kidney disease (CKD) in hypertensive adults. This association was particularly strong in men and individuals under 65.
Area of Science:
- Nephrology
- Hepatology
- Cardiovascular Medicine
Background:
- Limited data exists on the association between bilirubin levels and chronic kidney disease (CKD) risk in hypertensive patients.
- Hypertension is a major risk factor for CKD, necessitating identification of novel risk predictors.
Purpose of the Study:
- To investigate the relationship between Direct bilirubin (DBIL) and Indirect bilirubin (IBIL) and the risk of developing CKD.
- To assess whether bilirubin levels can serve as potential biomarkers for CKD risk in a hypertensive Chinese adult cohort.
Main Methods:
- A cohort study of 14,182 Chinese hypertensive adults (aged 27-96) was conducted.
- CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m².
- Multivariate logistic regression and restricted cubic spline analyses were used to assess the association between DBIL, IBIL, and CKD risk.
Main Results:
- The prevalence of CKD in the study population was 9.77%.
- Increased levels of both DBIL (OR: 0.66; 95% CI: 0.61, 0.71) and IBIL (OR: 0.75; 95% CI: 0.71, 0.81) were independently and negatively correlated with CKD risk.
- A linearly negative association between DBIL, IBIL, and CKD risk was confirmed. The association with IBIL was stronger in men and individuals <65 years.
Conclusions:
- DBIL and IBIL are independently and negatively associated with the risk of CKD in hypertensive adults.
- Bilirubin levels may serve as potential predictive markers for CKD in this population.
- The findings highlight the importance of considering bilirubin levels in CKD risk assessment and management strategies for hypertensive patients, especially younger males.
Abstract:
Limited data exists on the association between Direct bilirubin (DBIL) and Indirect bilirubin (IBIL) with the risk of chronic kidney disease (CKD) among patients with hypertension. This study aimed to assess the relationship between DBIL and IBIL with the risk of CKD in a cohort of Chinese adults diagnosed with hypertension. This study included 14 182 Chinese patients with hypertension between the ages of 27 and 96. CKD, the outcome variable, was defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 . The study employed multivariate linear and multivariate logistic regression analysis to evaluate the correlation between DBIL and IBIL with the risk of CKD. The prevalence of CKD in the study population was 9.77%. Multivariate logistic regression analysis showed that the increase in DBIL (OR: 0.66; 95% CI: 0.61, 0.71) and IBIL (OR: 0.75; 95% CI: 0.71, 0.81) were independently and negatively correlated with CKD. Further analyses using a restricted cubic spline (smooth-fitting curve) confirmed the linearly negative association between DBIL and IBIL with the risk of CKD. The subgroup analysis showed that the correlation between IBIL and CKD was stronger among men and populations <65 years of age (p for interaction <.05). DBIL and IBIL were independently and negatively associated with CKD. Furthermore, the correlation between DBIL and IBIL with CKD in the hypertensive population is more significant in those under 65 years of age. These findings may inform future strategies for the management of CKD.
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