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Estimated plasma osmolarity and risk of end-stage kidney disease in patients with IgA nephropathy.
Tanaka, Shigeru; Nakano, Toshiaki; Tokumoto, Masanori; Masutani, Kosuke; Tsuchimoto, Akihiro; Ooboshi, Hiroaki; Kitazono, Takanari.
Afiliación
  • Tanaka S; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Nakano T; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. toshink@med.kyushu-u.ac.jp.
  • Tokumoto M; Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan.
  • Masutani K; Department of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
  • Tsuchimoto A; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Ooboshi H; Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan.
  • Kitazono T; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Clin Exp Nephrol ; 24(10): 910-918, 2020 Oct.
Article en En | MEDLINE | ID: mdl-32594371
BACKGROUND: Several experimental studies have indicated that increased plasma osmolarity caused by recurrent dehydration is involved in kidney injury via a mechanism, mediated by vasopressin secretion and activation of the aldose reductase pathway. Epidemiologic evidence linking increased plasma osmolarity and the onset of end-stage kidney disease (ESKD), in patients with primary glomerulonephritis, is lacking. METHODS: We retrospectively examined 663 patients with IgA nephropathy (IgAN) diagnosed by kidney biopsy and evaluated the association between estimated plasma osmolarity and ESKD prevalence, using a Cox proportional hazards model. RESULTS: During follow-up (median 80.4 months; interquartile range 22.2-120.1), 73 patients developed ESKD. In a baseline survey, plasma osmolarity was correlated negatively with the mean value of the estimated glomerular filtration rate, but correlated positively with the mean value of urinary protein excretion, systolic blood pressure, and pathologic severity of extracapillary proliferation, in addition to tissue fibrosis and sclerosis. The incidence rate of ESKD increased linearly with increase in plasma osmolarity (P < 0.05 for trend). In multivariate analyses, plasma osmolarity was an independent risk factor for ESKD (hazard ratio for each increment of 5 mOsm/kg in plasma osmolarity 1.56; 95% confidence interval 1.18-2.07) even after adjustment for potential confounders. CONCLUSIONS: Increased plasma osmolarity was associated significantly with an increased risk of ESKD in patients with IgAN. Maintenance of plasma osmolarity by appropriate control of the balance between salt and water may contribute to kidney protection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Plasma / Glomerulonefritis por IGA / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Exp Nephrol Asunto de la revista: NEFROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Plasma / Glomerulonefritis por IGA / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Exp Nephrol Asunto de la revista: NEFROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón