Influence of OATP1B1 and OATP1B3 mutations and glomerular filtration rate on trough serum digoxin concentration in the Chinese population

Abstract Background We aimed to investigate the accuracy of different equations in evaluating estimated glomerular filtration rate (eGFR) in a Chinese population with different BMI levels. Methods A total of 837 Chinese patients were enrolled, and the eGFRs were calculated by three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, three full-age spectrum (FAS) equations and two Modification of Diet in Renal Disease (MDRD) equations. Results of measured GFR (mGFR) by the 99Tcm-diathylenetriamine pentaacetic acid (99Tcm-DTPA) renal dynamic imaging method were the reference standards. According to BMI distribution, the patients were divided into three intervals: below 25th(BMIP25), 25th to 75th(BMIP25–75) and over 75th percentiles (BMIP75). Results The medium BMI of the three BMI intervals were 20.9, 24.8 and 28.9 kg/m2, respectively. All deviations from mGFR (eGFR) were correlated with BMI (p < 0.05). The percentage of cases in which eGFR was within mGFR ±30% (P30) was used to represent the accuracy of each equation. Overall, eGFRFAS_Cr_CysC and eGFREPI_Cr_2009 performed similarly, showing the best agreement with mGFR among the eight equations in Bland-Altman analysis (biases: 4.1 and − 4.2 mL/min/1.73m2, respectively). In BMIP25 interval, eGFRFAS_Cr got − 0.7 of the biases with 74.2% of P30, the kappa value was 0.422 in classification of CKD stages and the AUC60 was 0.928 in predicting renal insufficiency, and eGFREPI_Cr_2009 got 2.3 of the biases with 71.8% of P30, the kappa value was 0.418 in classification of CKD stages and the AUC60 was 0.920 in predicting renal insufficiency. In BMIP25–75 interval, the bias of eGFRFAS_Cr_CysC was 4.0 with 85.0% of P30, the kappa value was 0.501 and the AUC60 was 0.941, and eGFRFAS_Cr_CysC showed balanced recognition ability of each stage of CKD (62.3, 63.7, 68.0, 71.4 and 83.3% respectively). In BMIP75 interval, the bias of eGFREPI_Cr_CysC_2012 was 3.8 with 78.9% of P30, the kappa value was 0.484 the AUC60 was 0.919, and eGFREPI_Cr_CysC_2012 equation showed balanced and accurate recognition ability of each stage (60.5, 60.0, 71.4, 57.1 and 100% respectively). In BMIP75 interval, the bias of eGFRFAS_Cr_CysC was − 1.8 with 78.5% of P30, the kappa value was 0.485, the AUC60 was 0.922. However, the recognition ability of each stage of eGFRFAS_Cr_CysC eq. (71.1, 61.2, 70.0, 42.9 and 50.0% respectively) was not as good as GFREPI_Cr_CysC_2012 equation. Conclusion For a Chinese population, we tend to recommend choosing eGFRFAS_Cr and eGFREPI_Cr_2009 when BMI was around 20.9, eGFRFAS_Cr_CysC when BMI was near 24.8, and eGFREPI_Cr_CysC_2012 when BMI was about 28.9.

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Associations of Serum Lipids and Lipoproteins with the Estimated Glomerular Filtration Rate in the Adult Chinese Population: A Cross-sectional Study

10.21203/rs.3.rs-24670/v1 ◽

2020 ◽

Author(s):

Xiaomu Kong ◽

Zhaojun Yang ◽

Bo Zhang ◽

Liping Yu ◽

Haiqing Zhu ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Chinese Population ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Adult Population ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Effective Control ◽

Lipids And Lipoproteins

Abstract Background: Dyslipidemia has a critical impact on renal dysfunction, but the exact types of lipids and lipoproteins that influence the estimated glomerular filtration rate (eGFR) are under investigation. Observations from an adult Chinese population ≥20 years old are lacking. The present study is to investigate the associations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) with eGFR, and the risks for a mildly and a moderately/severely reduced eGFR. Methods: A total of 16,206 participants from a national representative adult population (20 years of age or older) in China were included. All calculations were weighted based on the Chinese population data and the sampling scheme. Results: Upon stratifying the population based on lipids or lipoprotein categories, we observed a significantly lower mean eGFR as well as a higher estimated prevalence of impaired eGFR among Chinese adults with TG levels in the ranges of 1.7 mmol/L≤ TG <2.3 mmol/L [mean eGFR: 110.99 mL/min per 1.73 m 2 , P =0.0000; prevalence of mildly eGFR impairment: 30.92%, P =0.0000; prevalence of moderately/severely eGFR impairment: 2.01%, P =0.1842] and ≥2.3 mmol/L [111.62 mL/min per 1.73 m 2 , P =0.0000; 27.92%, P =0.0000; 2.81%, P =0.0174], compared to those among individuals with normal TG [122.03 mL/min per 1.73 m 2 ; 19.96%; 1.20%]. Also, a higher prevalence of mildly impaired eGFR was observed with 3.4 mmol/L≤ LDL-C <4.1 mmol/L (27.93%) compared with LDL-C <3.4 mmol/L (22.61%, P =0.0092). An elevated TG was proven to be an independent risk factor for decreased eGFR [β(SE) -0.0238(0.0039), P =0.0000], and each per mmol/L increase in TG was associated with the 1.19-fold and 1.31-fold increased risks for mildly impaired eGFR and moderately/severely impaired eGFR, respectively ( P =0.0000, 0.0001). A decreased HDL-C also showed a negative contribution to eGFR [-0.0883(0.0176), P =0.0000]. In contrast, increased TC was associated with increased eGFR [0.0314(0.0060), P =0.0000] and a reduction in the risk for mildly impaired eGFR by 0.91-fold ( P =0.0302). Increased LDL-C also contributed to an elevated eGFR [0.0251(0.0070), P =0.0004]. Conclusion: A decreased eGFR could be attributed independently to an elevated TG or reduced HDL-C. It emphasizes the importance of effective control of TG and HDL-C for preserving eGFR.

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