PMID- 29391834
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220311
IS  - 1179-1349 (Print)
IS  - 1179-1349 (Electronic)
IS  - 1179-1349 (Linking)
VI  - 10
DP  - 2018
TI  - Independent and combined effect of bilirubin and smoking on the progression of 
      chronic kidney disease.
PG  - 121-132
LID - 10.2147/CLEP.S150687 [doi]
AB  - OBJECTIVE: Whether serum bilirubin and cigarette smoking affect the risk of renal 
      function decline remains inconclusive. We aimed to test the independent and 
      combined effects of bilirubin and cigarette smoking on the progression of chronic 
      kidney disease (CKD) in hypertensive adults. METHODS: The study population 
      consisted of 12,633 patients in the renal sub-study of the China Stroke Primary 
      Prevention Trial. The primary outcome was progression of CKD, defined as a 
      decrease in estimated glomerular filtration rate (eGFR) of >/=30% and to a level of 
      <60 mL/min/1.73 m(2) if baseline eGFR was >/=60 mL/min/1.73 m(2), or a decrease in 
      eGFR of >/=50% if baseline eGFR was <60 mL/min/1.73 m(2), or end-stage renal 
      disease. The secondary outcomes included 1) rapid decline in renal function and 
      2) annual rate of eGFR decline. RESULTS: The median follow-up duration was 4.4 
      years. Cigarette smoking had no significant effect on the progression of CKD 
      (odds ratio [OR]: 1.11, 95% confidence interval [95% CI]: 0.78-1.57). However, a 
      significantly lower risk of the primary event (OR: 0.72, 95% CI: 0.55-0.95) was 
      found in participants in tertile 3 compared to those in tertiles 1-2 for total 
      bilirubin (TBiL) levels. More importantly, there was an interaction between TBiL 
      and smoking status on the primary outcome (P for interaction =0.013). Among ever 
      smokers, TBiL levels had no significant effect on the primary outcome. However, 
      among never smokers, higher TBiL levels were significantly associated with a 
      lower risk of the primary outcome (tertile 3 vs 1-2; OR: 0.53, 95% CI: 
      0.36-0.78). Similar trends were observed for direct bilirubin and secondary 
      outcomes. CONCLUSION: Among hypertensive patients, bilirubin was inversely 
      associated with the progression of CKD in never smokers, but not in ever smokers.
FAU - Wang, Jiancheng
AU  - Wang J
AD  - National Clinical Research Center for Kidney Disease, State Key Laboratory for 
      Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical 
      University, Guangzhou.
FAU - Wang, Binyan
AU  - Wang B
AD  - National Clinical Research Center for Kidney Disease, State Key Laboratory for 
      Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical 
      University, Guangzhou.
AD  - Institute for Biomedicine, Anhui Medical University, Hefei.
FAU - Liang, Min
AU  - Liang M
AD  - National Clinical Research Center for Kidney Disease, State Key Laboratory for 
      Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical 
      University, Guangzhou.
FAU - Wang, Guobao
AU  - Wang G
AD  - National Clinical Research Center for Kidney Disease, State Key Laboratory for 
      Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical 
      University, Guangzhou.
FAU - Li, Jianping
AU  - Li J
AD  - Department of Cardiology.
FAU - Zhang, Yan
AU  - Zhang Y
AD  - Department of Cardiology.
FAU - Huo, Yong
AU  - Huo Y
AD  - Department of Cardiology.
FAU - Cui, Yimin
AU  - Cui Y
AD  - Department of Pharmacy, Peking University First Hospital, Beijing.
FAU - Xu, Xiping
AU  - Xu X
AD  - National Clinical Research Center for Kidney Disease, State Key Laboratory for 
      Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical 
      University, Guangzhou.
AD  - Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key 
      Laboratory of Functional Dairy, College of Food Science and Nutritional 
      Engineering, China Agricultural University, Beijing, China.
FAU - Qin, Xianhui
AU  - Qin X
AD  - National Clinical Research Center for Kidney Disease, State Key Laboratory for 
      Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical 
      University, Guangzhou.
LA  - eng
PT  - Journal Article
DEP - 20180115
PL  - New Zealand
TA  - Clin Epidemiol
JT  - Clinical epidemiology
JID - 101531700
PMC - PMC5774486
OTO - NOTNLM
OT  - annual rate of eGFR decline
OT  - chronic kidney disease
OT  - cigarette smoking
OT  - hypertensive adults
OT  - rapid renal function decline
OT  - serum bilirubin
COIS- Disclosure Dr Xiping Xu reports grants from the Projects of the National Natural 
      Science Foundation of China (81473052); the Science and Technology Project of 
      Guangdong Province (2014B090904040); the Science and Technology Planning Project 
      of Guangzhou, China (201606211534575); and the Science, Technology and Innovation 
      Committee of Shenzhen (JSGG20160229173428526, KC2014JSCX0071A). Dr Xianhui Qin 
      reports grants from the Projects of the National Science Foundation (81402735). 
      Dr Binyan Wang reports grants from the National Key Research and Development 
      Program (2016YFC0903101, 2016YFC0904900). Dr Guobao Wang reports grants from the 
      Projects of the National Science Foundation (81670669). The authors report no 
      other conflicts of interest in this work.
EDAT- 2018/02/03 06:00
MHDA- 2018/02/03 06:01
PMCR- 2018/01/15
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/03 06:01 [medline]
PHST- 2018/01/15 00:00 [pmc-release]
AID - clep-10-121 [pii]
AID - 10.2147/CLEP.S150687 [doi]
PST - epublish
SO  - Clin Epidemiol. 2018 Jan 15;10:121-132. doi: 10.2147/CLEP.S150687. eCollection 
      2018.