Advertisement

 

 

Elevated bilirubin levels are associated with a better renal prognosis and ameliorate kidney fibrosis.

Elevated bilirubin levels are associated with a better renal prognosis and ameliorate kidney fibrosis.
Author Information (click to view)

Park S, Kim DH, Hwang JH, Kim YC, Kim JH, Lim CS, Kim YS, Yang SH, Lee JP,


Park S, Kim DH, Hwang JH, Kim YC, Kim JH, Lim CS, Kim YS, Yang SH, Lee JP, (click to view)

Park S, Kim DH, Hwang JH, Kim YC, Kim JH, Lim CS, Kim YS, Yang SH, Lee JP,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

PloS one 2017 02 2212(2) e0172434 doi 10.1371/journal.pone.0172434
Abstract
BACKGROUND
Bilirubin has been reported to protect against kidney injury. However, further studies highlighting the beneficial effects of bilirubin on renal fibrosis and chronic renal function decline are necessary.

METHODS
We assessed a prospective cohort with a reference range of total bilirubin levels. The primary outcome was a 30% reduction in the estimated glomerular filtration rate (eGFR) from baseline, and the secondary outcome was a doubling of the serum creatinine levels, halving of the eGFR and the initiation of dialysis. In addition, experiments with tubular epithelial cells and C57BL/6 mice were performed to investigate the protective effects of bilirubin on kidney fibrosis.

RESULTS
As a result, 1,080 patients were included in the study cohort. The study group with relative hyperbilirubinemia (total bilirubin 0.8-1.2 mg/dL) showed a better prognosis in terms of the primary outcome (adjusted hazard ratio (HR) 0.33, 95% confidence interval (CI) 0.19-0.59, P < 0.001) and the secondary outcome (adjusted HR 0.20, 95% CI 0.05 to 0.71, P = 0.01) than that of the control group. Moreover, the bilirubin-treated mice showed less fibrosis in the unilateral ureteral obstruction (UUO) model (P < 0.05). In addition, bilirubin treatment decreased fibronectin expression in tubular epithelial cells in a dose-dependent manner (P < 0.05). CONCLUSIONS
Mildly elevated serum bilirubin levels were associated with better renal prognosis, and bilirubin treatment induced a beneficial effect on renal fibrosis. Therefore, bilirubin could be a potential therapeutic target to delay fibrosis-related kidney disease progression.

Submit a Comment

Your email address will not be published. Required fields are marked *

fifteen + eleven =

[ HIDE/SHOW ]