{"title":"调节阴离子间隙与慢性肾病肾小球滤过率下降有关","authors":"Akashi Togawa, Satoko Uyama, Seiko Takanohashi, Megumi Shimasaki, Takehiko Miyaji, Hiroyuki Endo, Yoshihide Fujigaki","doi":"10.1159/000356461","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Metabolic acidosis is known to accelerate the progression of chronic kidney disease (CKD). However, whether undetermined anions as indicated by the adjusted anion gap (aAG) are associated with estimated glomerular filtration rate (eGFR) decline in patients with CKD is unclear.</p><p><strong>Methods: </strong>Data from 42 patients with CKD (baseline eGFR, 7.1-52.0 ml/min/ 1.73 m<sup>2</sup>) without massive proteinuria (urinary protein-creatinine ratio, UPCR <3.5) were retrospectively analyzed. aAG was calculated from serum sodium, serum chloride, serum bicarbonate, serum albumin, serum potassium, serum calcium and serum phosphate. The association between the percentage of the 6-month change of eGFR (%ΔeGFR/6m) and aAG was examined.</p><p><strong>Results: </strong>The mean baseline eGFR was 27.5 ± 11.1 ml/min/1.73 m<sup>2</sup> and the mean %ΔeGFR/6m was 13.8 ± 10.3. UPCR and aAG were 1.13 ± 0.93 and 9.48 ± 1.88, respectively. %ΔeGFR/6m was associated with aAG (r = 0.438, p < 0.005), but not with UPCR (r = 0.194, p = 0.218). In multivariate linear regression analyses, aAG remained significantly associated with %ΔeGFR/6m (β = 0.45, p < 0.01) after controlling for age, baseline eGFR, UPCR and HCO<sub>3</sub><sup>-</sup> concentration.</p><p><strong>Conclusion: </strong>These data suggest that aAG appears to be associated with the progression of CKD. aAG might be an independent predictor of CKD progression.</p>","PeriodicalId":56356,"journal":{"name":"Nephron Extra","volume":" ","pages":"113-117"},"PeriodicalIF":0.0000,"publicationDate":"2013-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000356461","citationCount":"5","resultStr":"{\"title\":\"Adjusted Anion Gap Is Associated with Glomerular Filtration Rate Decline in Chronic Kidney Disease.\",\"authors\":\"Akashi Togawa, Satoko Uyama, Seiko Takanohashi, Megumi Shimasaki, Takehiko Miyaji, Hiroyuki Endo, Yoshihide Fujigaki\",\"doi\":\"10.1159/000356461\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Metabolic acidosis is known to accelerate the progression of chronic kidney disease (CKD). However, whether undetermined anions as indicated by the adjusted anion gap (aAG) are associated with estimated glomerular filtration rate (eGFR) decline in patients with CKD is unclear.</p><p><strong>Methods: </strong>Data from 42 patients with CKD (baseline eGFR, 7.1-52.0 ml/min/ 1.73 m<sup>2</sup>) without massive proteinuria (urinary protein-creatinine ratio, UPCR <3.5) were retrospectively analyzed. aAG was calculated from serum sodium, serum chloride, serum bicarbonate, serum albumin, serum potassium, serum calcium and serum phosphate. The association between the percentage of the 6-month change of eGFR (%ΔeGFR/6m) and aAG was examined.</p><p><strong>Results: </strong>The mean baseline eGFR was 27.5 ± 11.1 ml/min/1.73 m<sup>2</sup> and the mean %ΔeGFR/6m was 13.8 ± 10.3. UPCR and aAG were 1.13 ± 0.93 and 9.48 ± 1.88, respectively. %ΔeGFR/6m was associated with aAG (r = 0.438, p < 0.005), but not with UPCR (r = 0.194, p = 0.218). In multivariate linear regression analyses, aAG remained significantly associated with %ΔeGFR/6m (β = 0.45, p < 0.01) after controlling for age, baseline eGFR, UPCR and HCO<sub>3</sub><sup>-</sup> concentration.</p><p><strong>Conclusion: </strong>These data suggest that aAG appears to be associated with the progression of CKD. aAG might be an independent predictor of CKD progression.</p>\",\"PeriodicalId\":56356,\"journal\":{\"name\":\"Nephron Extra\",\"volume\":\" \",\"pages\":\"113-117\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2013-11-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1159/000356461\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nephron Extra\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000356461\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2013/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nephron Extra","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000356461","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2013/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5
摘要
背景:已知代谢性酸中毒可加速慢性肾脏疾病(CKD)的进展。然而，由调整阴离子间隙(aAG)指示的未确定阴离子是否与CKD患者肾小球滤过率(eGFR)的估计下降有关尚不清楚。方法:数据来自42例无大量蛋白尿(尿蛋白-肌酐比，UPCR)的CKD患者(基线eGFR, 7.1-52.0 ml/min/1.73 m2)。结果:平均基线eGFR为27.5±11.1 ml/min/1.73 m2，平均%ΔeGFR/6m为13.8±10.3。UPCR为1.13±0.93,aAG为9.48±1.88。%ΔeGFR/6m与aAG相关(r = 0.438, p < 0.005)，与UPCR无关(r = 0.194, p = 0.218)。在多元线性回归分析中，在控制年龄、基线eGFR、UPCR和HCO3-浓度后，aAG与%ΔeGFR/6m仍有显著相关性(β = 0.45, p < 0.01)。结论:这些数据表明aAG似乎与CKD的进展有关。aAG可能是CKD进展的独立预测因子。
Adjusted Anion Gap Is Associated with Glomerular Filtration Rate Decline in Chronic Kidney Disease.
Background: Metabolic acidosis is known to accelerate the progression of chronic kidney disease (CKD). However, whether undetermined anions as indicated by the adjusted anion gap (aAG) are associated with estimated glomerular filtration rate (eGFR) decline in patients with CKD is unclear.
Methods: Data from 42 patients with CKD (baseline eGFR, 7.1-52.0 ml/min/ 1.73 m2) without massive proteinuria (urinary protein-creatinine ratio, UPCR <3.5) were retrospectively analyzed. aAG was calculated from serum sodium, serum chloride, serum bicarbonate, serum albumin, serum potassium, serum calcium and serum phosphate. The association between the percentage of the 6-month change of eGFR (%ΔeGFR/6m) and aAG was examined.
Results: The mean baseline eGFR was 27.5 ± 11.1 ml/min/1.73 m2 and the mean %ΔeGFR/6m was 13.8 ± 10.3. UPCR and aAG were 1.13 ± 0.93 and 9.48 ± 1.88, respectively. %ΔeGFR/6m was associated with aAG (r = 0.438, p < 0.005), but not with UPCR (r = 0.194, p = 0.218). In multivariate linear regression analyses, aAG remained significantly associated with %ΔeGFR/6m (β = 0.45, p < 0.01) after controlling for age, baseline eGFR, UPCR and HCO3- concentration.
Conclusion: These data suggest that aAG appears to be associated with the progression of CKD. aAG might be an independent predictor of CKD progression.
期刊介绍：
An open-access subjournal to Nephron. ''Nephron EXTRA'' publishes additional high-quality articles that cannot be published in the main journal ''Nephron'' due to space limitations.
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