Jun Wang1, Peng Guo2, ZhengYan Gao3, BenGang Zhou4, Lei Ren5, Yu Chen6, Quan Zhou7. 1. Department of Hepatobiliary and Pancreatic Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China. 2. Department of Hepatobiliary and Pancreatic Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, China. 3. Department of Urology, The Sixth People's Hospital of Yancheng City, Yancheng, 224000, China. 4. Department of Gastroenterology, Huangshi Central Hospital of E Dong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, 435000, China. 5. Department of Joint Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China. 6. Department of Spinal Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China. 7. Department of Science and Education, The First People's Hospital of Changde City, No. 318 Renming Road, Changde, 415003, Hunan, China. zhouquan402@163.com.
Abstract
AIMS: Previous studies have indicated the link of bilirubin levels and risk of developing chronic kidney disease (CKD); however, the findings were inconsistent. METHODS: We searched for cohort studies examining bilirubin as an exposure and CKD as an outcome in the Medline, EMBASE, and Web of Science databases from inception through November 31, 2016. A generalized least-squares approach was applied to assess the dose-response relationship between them by pooling rate ratios with 95% confidence intervals. Subgroup analyses, sensitivity analysis, meta-regression, and publication bias were also conducted. RESULTS: Seven cohort studies with 1316 cases and 21,076 participants were identified for inclusion in the meta-analysis. The combined RR for the highest versus lowest bilirubin level was 0.36 (95% CI 0.19-0.68; P heterogeneity = 0.001; Power = 0.72; n = 6). In the linear dose-response analysis, each 1-μmol/L increase in bilirubin was associated with a 5% reduced risk of CKD (RR = 0.95; 95% CI 0.92-0.97; P for trend test = 0.113; P heterogeneity = 0.001; Power = 0.99; n = 7). The subgroup analyses and sensitivity analyses showed consistent results, and publication bias may exist. CONCLUSION: This meta-analysis suggests that elevated bilirubin level may be associated with decreased risk of developing CKD.
AIMS: Previous studies have indicated the link of bilirubin levels and risk of developing chronic kidney disease (CKD); however, the findings were inconsistent. METHODS: We searched for cohort studies examining bilirubin as an exposure and CKD as an outcome in the Medline, EMBASE, and Web of Science databases from inception through November 31, 2016. A generalized least-squares approach was applied to assess the dose-response relationship between them by pooling rate ratios with 95% confidence intervals. Subgroup analyses, sensitivity analysis, meta-regression, and publication bias were also conducted. RESULTS: Seven cohort studies with 1316 cases and 21,076 participants were identified for inclusion in the meta-analysis. The combined RR for the highest versus lowest bilirubin level was 0.36 (95% CI 0.19-0.68; P heterogeneity = 0.001; Power = 0.72; n = 6). In the linear dose-response analysis, each 1-μmol/L increase in bilirubin was associated with a 5% reduced risk of CKD (RR = 0.95; 95% CI 0.92-0.97; P for trend test = 0.113; P heterogeneity = 0.001; Power = 0.99; n = 7). The subgroup analyses and sensitivity analyses showed consistent results, and publication bias may exist. CONCLUSION: This meta-analysis suggests that elevated bilirubin level may be associated with decreased risk of developing CKD.
Authors: Seung Seok Han; Ki Young Na; Dong-Wan Chae; Yon Su Kim; Suhnggwon Kim; Ho Jun Chin Journal: Tohoku J Exp Med Date: 2010-06 Impact factor: 1.848