Individual Kidney Function Research Articles

The effect of TSH on kidney function

Background: The thyroid gland plays a vital role in the regulation of many physiological processes, including kidney function. Aim: The purpose of this study was to investigate the relationship between thyroid-stimulating hormone (TSH) and kidney function in male and female patients with hyperthyroidism, as well as in healthy control subjects. Method: A total of 60 participants from Najaf city, Iraq, were included in the study. This included 10 male and 10 female control subjects, as well as 20 male and 20 female patients with hyperthyroidism. Blood samples were collected from all participants and analyzed for TSH, urea, and creatinine levels. Result: The results showed a significant increase in TSH levels in both male and female patients with hyperthyroidism compared to control subjects. Urea levels were also significantly higher in hyperthyroidism patients compared to controls, while creatinine levels were not significantly different. In addition, there was a significant difference in the effects of TSH on kidney function between male and female patients with hyperthyroidism. Female patients with hyperthyroidism had significantly higher levels of urea and lower levels of creatinine compared to male patients with hyperthyroidism. These findings suggest a direct effect of TSH on kidney function and highlight the need for regular monitoring of kidney function in individuals with hyperthyroidism, particularly women. Further research is needed to fully understand the mechanisms behind the gender differences observed in this study and to develop targeted interventions for both men and women with thyroid disorders. Conclusion: our study provides valuable insights into the relationship between TSH and kidney function and highlights the need for multidisciplinary care and targeted interventions for individuals with thyroid disorders to prevent or minimize the risk of kidney dysfunction.

Much ado about nothing: the impact of coronary angiography on kidney function in individuals with chronic kidney disease

Abstract Background and Objectives Chronic kidney disease (CKD) is associated with premature coronary artery disease and an increased risk of cardiovascular morbidity and mortality (1). Historically, there has been a tendency to delay or even avoid coronary angiography (CA) in those with CKD due to an increased risk of contrast-induced nephropathy or concern over precipitating the need for chronic dialysis. Such "renal nihilism" may account for the poorer outcomes observed in CKD patients who present with acute coronary syndromes (2). The role of this retrospective analysis was to evaluate the impact of CA on the temporal trend in kidney function in individuals with CKD over a 24-month period. Methods The clinical details of 120 individuals under long-term local follow-up by various Nephrology clinics (CKD clinic, low creatine clearance, polycystic kidney disease, transplant and immunosuppression clinics) was collected. All underwent CA locally. Kidney function was observed at set intervals of 12-, 9-, 6- and 3-months prior to CA, immediately post-CA, and at 3-, 6-, 9- and 12-months post-CA. Only results obtained after the desired time point but within 28 days were included. All CAs regardless of either their indication (elective or urgent) or whether percutaneous intervention (PCI) was performed, were included. Patients already on dialysis at the time of the CA were excluded. Statistical analysis was performed via one-way ANOVA. Results Patient characteristics are summarised in table 1. The average age of patients was 67, with a male preponderance (72%). 22% had CKD 3, 24% had CKD 4 and 12% had CKD 5. 9% were kidney transplant recipients. 37% underwent urgent CA whilst a total of 22% had PCI. 27% progressed to requiring renal replacement therapy (RRT). The mean length to RRT was 2.8 years. The rate of decline in kidney function in the last 12 months prior to CA was 7.7% and 6.3% in the year after CA (figure 1). There was no statistically significant difference in kidney function after CA (p = 0.395). This was replicated in analyses focussing on CKD classes 3, 4 and 5 individually, within stable kidney transplant recipients, and within analysis comparing PCI vs non-intervention CAs. Conclusion The results demonstrate CA does not accelerate the decline in kidney function in those with known CKD over a 12-month period, and suggests where appropriate, an invasive treatment strategy should be consider and utilised more often in this population.Table 1:Patient characteristicsFigure 1:Trend in eGFR relative to CA

Association between albumin-corrected anion gap and kidney function in individuals with hypertension – NHANES 2009–2016 cycle

Objectives Long-term uncontrolled hypertension increases the risk of kidney decompensation. This study aimed to explore the connection between albumin-corrected anion gap (ACAG) and kidney function in hypertensive patients. Methods This study utilized data from 1988 participants diagnosed with hypertension sourced from the NHANES database. Binary logistic regression analysis and subgroup analysis were utilized to investigate the relationship between ACAG and kidney function. The study employed restricted cubic spline (RCS) to assess the non-linear associations between ACAG and eGFR, as well as ACAG and ACR. Furthermore, mediation and moderation effect analyses were carried out, with blood pressure serving as the mediator and moderator, ACAG as the independent variable, and eGFR and ACR as the dependent variables. Finally, the study developed ACAG-based models for predicting kidney function decline. Results Higher ACAG is identified as an independent risk factor for eGFR < 60 mL/minute/1.73 m2 and ACR ≥ 30 mg/g. Results from RCS indicate a non-linear relationship between ACAG and eGFR, as well as between ACAG and ACR. The mediation effect analysis revealed that DBP mediated the relationship between ACAG and eGFR. Analysis on moderation effect demonstrated that SBP played a significant role in moderating the interaction between ACAG and ACR. Moreover, the models based on ACAG showed strong performance. Conclusions The levels of ACAG are found to be independently associated with both eGFR and ACR. Additionally, ACAG shows promise as a new and dependable biomarker for predicting the decline in kidney function in hypertensive patients.

Effect of spironolactone wash-out on albuminuria after long-term treatment in individuals with type 2 diabetes and high risk of kidney disease-An observational follow-up of the PRIORITY study.

This study aimed to explore the effect of discontinuation of long-term spironolactone treatment on markers of kidney function in individuals with type 2 diabetes (T2D) at high risk of kidney disease enrolled in the Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe 2 diabetic patients with normoalbuminuria (PRIORITY) study. An observational study following the nested randomised part of the PRIORITY study was conducted. A total of 115 individuals with T2D and normoalbuminuria but high risk for progression based on urinary proteomics, randomised to daily spironolactone (n = 50) or placebo (n = 65) for a median of 2.5 years, were re-examined approximately 6 weeks after the final visit in the PRIORITY study. Primary endpoint was relative change in geometric mean of urinary albumin-creatinine ratio (UACR) between the final visit in PRIORITY (baseline) and follow-up. Secondary endpoints were change in estimated glomerular filtration rate (eGFR), systolic blood pressure (SBP) and serum potassium. No change in UACR was observed in neither the spironolactone (geometric mean change: 17%; 95% CI -12, 55; p = 0.28) nor the placebo (5%; 95% CI -13, 26; p = 0.63) group at follow-up. No difference in UACR between the groups was observed at follow-up (relative difference in geometric mean: 11%, 95% CI -26, 67; p = 0.60). For eGFR and SBP, an increase after discontinuation of spironolactone was observed, as well as for SBP after placebo discontinuation. Potassium levels were lower after discontinuation of spironolactone, but higher after placebo discontinuation (all p < 0.05). UACR did not change after discontinuation of long-term treatment with spironolactone. However, an increase in eGFR was observed supporting a haemodynamic effect of spironolactone in the kidneys.

Obesity, kidney and metabolic bariatric surgery: a surgeon’s narrative review

Excess body weight impacts kidney function in individuals with severe obesity, primarily through metabolic alterations in adipocytes, especially in visceral adipose tissue. The relationship between persistent sterile inflammation associated with obesity and the progression of obesity-related kidney disease to chronic kidney disease (CKD) is an area of growing interest. The beneficial effects of weight loss on the prevention of kidney disease and the improvement of kidney function in individuals with obesity have been well documented. Currently, the most effective weight loss strategy is metabolic bariatric surgery (MBS), which has been proven to not only prevent the progression of CKD but also reverse it. However, awareness and understanding of the impact of obesity on the kidney should also extend to the severely obese population with clinically normal renal function. The purpose of this review is to outline the current knowledge on the pathophysiology of obesity-induced kidney damage, the effects of MBS on renal function in severely obese individuals with or without CKD, and provide the current evidence on perioperative management strategies for CKD patients, including diet and nutrition.

Exploring Adiposity and Chronic Kidney Disease: Clinical Implications, Management Strategies, Prognostic Considerations.

Obesity poses a significant and growing risk factor for chronic kidney disease (CKD), requiring comprehensive evaluation and management strategies. This review explores the intricate relationship between obesity and CKD, emphasizing the diverse phenotypes of obesity, including sarcopenic obesity and metabolically healthy versus unhealthy obesity, and their differential impact on kidney function. We discuss the epidemiological evidence linking elevated body mass index (BMI) with CKD risk while also addressing the paradoxical survival benefits observed in obese CKD patients. Various measures of obesity, such as BMI, waist circumference, and visceral fat assessment, are evaluated in the context of CKD progression and outcomes. Mechanistic insights into how obesity promotes renal dysfunction through lipid metabolism, inflammation, and altered renal hemodynamics are elucidated, underscoring the role of adipokines and the renin-angiotensin-aldosterone system. Furthermore, the review examines current strategies for assessing kidney function in obese individuals, including the strengths and limitations of filtration markers and predictive equations. The management of obesity and associated comorbidities like arterial hypertension, type 2 diabetes mellitus, and non-alcoholic fatty liver disease in CKD patients is discussed. Finally, gaps in the current literature and future research directions aimed at optimizing the management of obesity-related CKD are highlighted, emphasizing the need for personalized therapeutic approaches to mitigate the growing burden of this intertwined epidemic.

Relationship between phthalate exposure and kidney function in Taiwanese adults as determined through covariate-adjusted standardization and cumulative risk assessment

Few studies have investigated the associations between phthalate exposure and kidney function indicators in adults by simultaneously performing covariate-adjusted creatinine standardization, cumulative risk assessment, and mixture analysis. Thus, we applied these methods simultaneously to investigate the aforementioned associations in an adult population. This cross-sectional study analyzed data (N = 839) from a community-based arm of the Taiwan Biobank. The levels of 10 urinary phthalate metabolites were measured and calculated as the sum of the molar concentrations of the dibutyl phthalate metabolite (ΣDBPm) and di(2-ethylhexyl) phthalate (DEHP) metabolite (ΣDEHPm). The hazard index (HI) and daily intake (DI) were estimated by measuring the urinary levels of the phthalate metabolite. Kidney function biomarkers were assessed by measuring the following: blood urea nitrogen (BUN), uric acid, the albumin-to-creatinine ratio (ACR), and the estimated glomerular filtration rate (eGFR). Generalized linear models were implemented to examine the associations between exposure to individual phthalates, HI scores, and kidney function biomarkers. We also employed Bayesian kernel machine regression (BKMR) to analyze the relationships between exposure to various combinations of phthalates and kidney function. ΣDEHPm levels were significantly and positively associated with BUN and ACR levels, and ΣDBPm levels were positively associated with ACR levels. In addition, eGFR was negatively associated with ΣDBPm and ΣDEHPm levels. In the BKMR model, a mixture of 10 phthalate metabolites was significantly associated with BUN, uric acid, ACR, and eGFR results. Higher DIDEHP and higher DIDnBP values were significantly associated with lower eGFRs and higher ACRs, respectively. Higher DIDiBP and DIDEP values were significantly associated with higher uric acid levels. A higher HI was significantly associated with lower eGFRs and higher ACRs. Our results suggest that exposure to environmental phthalates is associated with impaired kidney function in Taiwanese adults.

Financial Benefits of Renal Dose-Adjusted Dipeptidyl Peptidase-4 Inhibitors for Patients with Type 2 Diabetes and Chronic Kidney Disease.

Dipeptidyl peptidase-4 (DPP4) inhibitors are frequently prescribed for patients with type 2 diabetes; however, their cost can pose a significant barrier for those with impaired kidney function. This study aimed to estimate the economic benefits of substituting non-renal dose-adjusted (NRDA) DPP4 inhibitors with renal dose-adjusted (RDA) DPP4 inhibitors in patients with both impaired kidney function and type 2 diabetes. This retrospective cohort study was conducted from January 1, 2012 to December 31, 2018, using data obtained from common data models of five medical centers in Korea. Model 1 applied the prescription pattern of participants with preserved kidney function to those with impaired kidney function. In contrast, model 2 replaced all NRDA DPP4 inhibitors with RDA DPP4 inhibitors, adjusting the doses of RDA DPP4 inhibitors based on individual kidney function. The primary outcome was the cost difference between the two models. In total, 67,964,996 prescription records were analyzed. NRDA DPP4 inhibitors were more frequently prescribed to patients with impaired kidney function than in those with preserved kidney function (25.7%, 51.3%, 64.3%, and 71.6% in patients with estimated glomerular filtration rates [eGFRs] of ≥60, <60, <45, and <30 mL/min/1.73 m2, respectively). When model 1 was applied, the cost savings per year were 7.6% for eGFR <60 mL/min/1.73 m2 and 30.4% for eGFR <30 mL/min/1.73 m2. According to model 2, 15.4% to 51.2% per year could be saved depending on kidney impairment severity. Adjusting the doses of RDA DPP4 inhibitors based on individual kidney function could alleviate the economic burden associated with medical expenses.

Kidney outcomes with SGLT2 inhibitor vs. DPP4 inhibitor use in older adults with diabetes.

While the kidney protective effects of sodium glucose co-transporter-2 (SGLT2) inhibitors have attracted much attention, there are limited real-world clinical data examining the effects of SGLT2 inhibitors on kidney function in older individuals. We aimed to compare the kidney outcomes between SGLT2 inhibitor and dipeptidyl peptidase 4 (DPP4) inhibitor use in older adults with diabetes. Using a nationwide claims database, we studied 6354 older adults (≥ 60 years of age) who had diabetes and newly initiated on SGLT2 inhibitors or DPP4 inhibitors. A 1:4 propensity score matching algorithm was used to compare changes in eGFR between SGLT2 inhibitor and DPP4 inhibitor users. The primary outcome was a decline in the rate of estimated glomerular filtration rate (eGFR), which was obtained using a linear mixed-effects model with an unstructured covariance. Following propensity score matching, 6354 individuals including 1271 SGLT2 inhibitor users and 5083 DPP4 inhibitor users (median age: 68 [65-70] years); men, 60.4%; median eGFR:69.0 [59.1-79.0] ml/min/1.73 m2, median hemoglobin A1c [HbA1c]:6.9 [6.5-7.4]%) were analyzed. SGLT2 inhibitor users had a slower eGFR decline than did DPP4 inhibitor users (-0.97 [95% CI, -1.24 to -0.70] ml/min/1.73m2 vs. -1.83 [95% CI, -1.97 to -1.69] ml/min/1.73m2 per year; p for interaction<0.001). This finding remained consistent across subgroups based on age, sex, body mass index, HbA1c level, renin-angiotensin system inhibitor use, and baseline eGFR. Additionally, the risk of a≥20%, ≥ 30%, and≥40% decrease in eGFR from baseline was significantly lower in SGLT2 inhibitor users than that in DPP4 inhibitor users. Our analysis, utilizing a nationwide epidemiological dataset, demonstrated that the decline in eGFR was slower in individuals aged≥60 years with diabetes who were prescribed SGLT2 inhibitors compared to those prescribed DPP4 inhibitors, suggesting a potential advantage of SGLT2 inhibitors for kidney outcomes even in older individuals with diabetes.

A hormonal side effect of anabolic steroids among a sample of Baghdad male bodybuilders

Anabolic-androgenic steroids (AAS) are used widely, but in illegal ways mostly by young men as performance-enhancing and image-enhancing drugs (IPED). long-term usage of AAS, usually in conjunction with other illegal substances, can have extremely detrimental impacts on the reproductive system. The primary goal of this study was to examine any possible detrimental effects of AAS on sex hormone levels, a liver and kidney function in individuals who frequent fitness centers in Iraq-Baghdad. In this research, there are 60 participants (20–37 years old); 30 athletes who visited the different gyms in Baghdad/ Iraq and used AAS such as testosterone, Boldenone, Cybontae, Deca Durabellin; and 30 athletes who did not take any synthetics hormones and serve as control. All participants answered the questionnaire form which included their age, the type of used AAS, when they started to take it, and the total usage number per week. The blood (5 ml) was drawn from every participant to separate the serum. The serum was used to measure some hormones (Testosterone, FSH, LH, prolactin and Estrodiol) and liver and kidney function parameters. The results showed a significantly lower level of testosterone and FSH in the AAS-users’ bodybuilding group compared to the control group. In comparison with the control group, there was a notable rise in the PRL level in the serum of AA users. However, when comparing the serum levels of LH and Estrodiol in the AAS-user group to those in the control group, no discernible variations were seen. AAS users had a significantly higher level of ALT and lower ALP than controls, although there is no difference in AST levels between the two groups. The creatine level was significantly higher in the AAS-user compared to the control group, but not urea. In conclusion, the effects of AAS and other supplements on sex hormones and kidney, liver function, and vary depending on how long they are used, with the effects of AAS being more pronounced. Therefore, there is a need for culturally sensitive measures to prevent steroid abuse among youth.

APOL1 Kidney Risk Variants and Long-Term Kidney Function in Healthy Middle-Aged Black Individuals: The Atherosclerosis Risk in Communities (ARIC) Study

Rationale and ObjectiveImpact of Apolipoprotein L1(APOL1) genotype on future risk of kidney disease among middle-aged individuals with good kidney function is not well established. Study DesignLongitudinal cohort study. Setting & Participants5,886 healthy individuals, 45-64 years old, enrolled in the Atherosclerosis Risk in Communities study with eGFRcr ≥ 80 mL/min who would be suitable kidney donors. ExposuresRace and APOL1 genotype OutcomesEGFRcr-cys using CKD-EPI 2021 equation, uACR, proportion with CKD 3a or worse, ESKD and death. Analytical ApproachParticipants grouped on race and APOL1 genotype. Compared eGFRcr-cys and uACR across groups. Multinomial logistic regression models were used compare odds of CKD. Kaplan-Meier survival curves were created to compare rates of ESKD and death at last follow-up. ResultsThere were 5,075 whites (86%), 701 Blacks carrying low-risk APOL1 genotype (12%) and 110 Blacks carrying high-risk APOL1 genotype (2%). The mean age at baseline was 53±6 years. At 10 years, white participants had lower eGFRcr-cys than low-risk and high-risk groups (89±16 vs. 91±16 and 92±15 mL/min/1.73m2, respectively; p <0.001). At 25 years, white participants continued to have lower eGFRcr-cys than low-risk group (70±18 vs. 72±19 mL/min/1.73m2; p <0.001) but not compared to high risk APOL1 genotype (67±23 mL/min/1.7m2). There was no difference in uACR among groups at 10 and 25 years (p=0.87 and 0.91 respectively). The odds of developing CKD Stage 3a or worse were not different between low-risk and high-risk APOL1 group in both unadjusted and adjusted models (p=0.26 and p=0.39, respectively). At last follow-up, < 5% developed ESKD and 45% of individuals either died or reached ESKD with no difference in outcomes between the groups. LimitationsLow ascertainment due to death and long follow-up ConclusionsAmong middle-aged individuals, APOL1 genotype does not appear to be a major driver of future risk of kidney disease.

548 Metformin normalizes impaired renal and cardiac function in a rat model of transient undernutrition

OBJECTIVES/GOALS: In the U.S., over 4 million people including children experience transient periods of undernutrition annually. Cardio-metabolic and renal diseases are more prevalent in this population. We are investigating therapeutic strategies to reverse the long-term risk of these diseases in a rat model of transient undernutrition followed by refeeding. METHODS/STUDY POPULATION: Thirty six female Fischer rats (3-months of age) were initially divided into 2 groups. Half were fed regular chow (CT) while the other half were severely food restricted (sFR) by 60% from 0-2 weeks (wks) followed by refeeding from 2-14 wks (sFR-Refed). These 2 groups were then subdivided and treated ± metformin (Met) from wk 7 to wk 12 (n=9/group). High precision ultrasound was conducted on live rats to assess heart and kidney function immediately after the sFR period ended (wk 2) and at the end of the study (wk 14). At the conclusion of the experiment, the rats were sacrificed and the histology of the kidney and heart tissues were analyzed in hematoxylin and eosin-stained sections. The protein to DNA ratio was also calculated in homogenates from these tissues. RESULTS/ANTICIPATED RESULTS: In sFR-Refed rats, cardiac output (CO), heart rate (HR) and renal artery blood flow (RBF) were decreased by 11 ± 1.5%#, 7.0 ± 6.0% and 22 ± 0.6%#, respectively, compared to control (CT) rats; #p&lt;0.05. Mean glomerular diameter was reduced in the kidneys of sFR-refed rats compared to CT and this effect was attenuated by metformin treatment [(µm): CT, 406 ± 31; sFR-Refed, 383 ± 11, p&lt;0.06; CT+Met, 393 ± 18; sFR-Refed+Met, 407 ± 18*]. Furthermore, the mean cardiomyocyte thickness was reduced in sFR-Refed rats compared to controls while metformin treatment prevented this effect [(µm): CT, 16.4 ± 3.6; sFR-Refed, 11.5 ± 2.3#; CT+Met, 16.4 ± 3.6; sFR-Refed+Met, 15.9 ± 3.2*]. #p&lt;0.05 vs. CT, same treatment; *p&lt;0.05 vs. Met, same diet; two-way ANOVA. DISCUSSION/SIGNIFICANCE: These findings have promising implications for metformin use to mitigate long-term impairments in heart and kidney structure and function in individuals who have experienced bouts of undernutrition earlier in life for either voluntarily (e.g., very low calorie dieting) or involuntary (e.g., very low food security) reasons.

Geriatric Nutritional Risk Index as a Possible Predictor of Decline in Kidney Function in Older People.

The Geriatric Nutritional Risk Index (GNRI) is associated with morbidity and mortality in older individuals. Our study explored the relationship between GNRI, decline in kidney function, and all-cause mortality in older individuals. This retrospective cohort study analyzed data from participants aged ≥60 years who underwent a general health checkup between 2002 and 2018. The primary exposure was the GNRI, divided into quartiles. The primary and secondary outcomes were a decline in kidney function assessed using the 5-year estimated glomerular filtration rate (eGFR) and all-cause mortality, respectively. The analysis included a total of 1,599 participants (median age, 63 years; interquartile range [IQR], 61-67; 54% males). The mean±standard deviation of GNRI was 114±7. Compared with the highest GNRI quartile, the lower GNRI quartiles were associated with steeper 5-year slopes in eGFR, with a fully adjusted beta coefficient and 95% confidence intervals (CIs) of -0.50 (-0.86, -0.14), -0.29 (-0.63, 0.05), and -0.19 (-0.53, 0.14) for the first, second, and third GNRI quartiles, respectively. The median follow-up duration was 7.4 years (IQR, 4.6-12.4). During this period, we identified 108 deaths (7.8 per 1,000 person-years). The first GNRI quartile was associated with all-cause mortality compared to the highest GNRI quartile (hazard ratio of 2.20; 95% CI 1.23, 3.95). Nutritional status, as evaluated using the GNRI, was associated with 5-year changes in kidney function and all-cause mortality in older individuals.

Deterioration of Kidney Function Is Affected by Central Arterial Stiffness in Late Life.

Cardiovascular diseases affect kidney function. The aim of this study was to investigate the possible associations between hemodynamic parameters and change in kidney function in individuals aged 75 years and older. Data on hemodynamics and blood and urine samples were collected at baseline and during one-year visits. Hemodynamics were split into two groups based on median values. Changes in the estimated glomerular filtration rate (eGFR) were investigated between low and high groups for each hemodynamic parameter using analysis of variance. Changes in the albumin-creatinine ratio (ACR) were examined as binary outcomes (large increase vs. stable) using logistic regression. The population consisted of 252 participants. Participants in the high central systolic blood pressure (cSBP) group had a greater decline in eGFR than participants in the low cSBP group (-6.3% vs. -2.7%, p = 0.006). Participants in the high aortic pulse wave velocity (aPWV) group had a greater decline in eGFR than those in the low aPWV group (-6.8% vs. -2.5%, p = 0.001). Other hemodynamic parameters were not associated with eGFR changes. Hemodynamics were not associated with changes in the ACR; aPWV and cSBP appear to be predictors for eGFR decline in older age; monitoring and treatment of elevated stiffness might be helpful in order to prevent kidney function decline.

A Investigation of Kidney Function in the Hypo-Thyroidism Individuals at the Tertiary Healthcare Centre

The most prevalent endocrine illnesses worldwide are thyroid disorders. India is also no different. There are thought to be 42 million thyroid ailment sufferers in India, based on projections from numerous research on the condition. to investigate Kidney function in hypo-thyroid individuals at a tertiary medical facility. This cross-sectional investigation was conducted over a one-year period in 100 hypo-thyroid individuals at a Medical College and Hospital in Central India after receiving approval from the institutional ethical committee. The investigation includes similar euthyroid participants in addition to the diagnosed hypo-thyroidism individuals who provided consent. Both groups underwent the kidney function test, which included indicators such as creatinine clearance, creatinine urea, and uric acid, among others. Unpaired t-test statistics were computed using SPSS version 22 software. 49 -16%, 50-59 12%, and &gt;60 10%. Women individuals made up 66% of the total population, with male individuals making up 24%. The Creatinine Clearance was considerably poorer in the hypo-thyroidism individuals compared to controls, measuring 102.08±9.98, 80.74±10.56 (P 0.001), Creatinine -0.82±0.102, 0.726±0.0456 (P 0.001), Urea -28.18±3.18, 21.82±3.01 (P 0.001), and Uric acid - 5.082±0.7614, 3.124±0.158 (P 0.001). According to the results of our investigation, the majority of hypo-thyroid individuals were women and in the age range of 30-39. They also demonstrated significantly abnormal kidney function tests, such as lower creatinine clearance and higher creatinine, urea, and uric acid levels in comparison to euthyroid individuals.

Insulin Secretion, Sensitivity, and Kidney Function in Young Individuals With Type 2 Diabetes.

β-Cell dysfunction and insulin resistance magnify the risk of kidney injury in type 2 diabetes. The relationship between these factors and intraglomerular hemodynamics and kidney oxygen availability in youth with type 2 diabetes remains incompletely explored. Fifty youth with type 2 diabetes (mean age ± SD 16 ± 2 years; diabetes duration 2.3 ± 1.8 years; 60% female; median HbA1c 6.4% [25th, 75th percentiles 5.9, 7.6%]; BMI 36.4 ± 7.4 kg/m2; urine albumin-to-creatinine ratio [UACR] 10.3 [5.9, 58.0] mg/g) 21 control participants with obesity (OCs; age 16 ± 2 years; 29% female; BMI 37.6 ± 7.4 kg/m2), and 20 control participants in the normal weight category (NWCs; age 17 ± 3 years; 70% female; BMI 22.5 ± 3.6 kg/m2) underwent iohexol and p-aminohippurate clearance to assess glomerular filtration rate (GFR) and renal plasma flow, kidney MRI for oxygenation, hyperglycemic clamp for insulin secretion (acute C-peptide response to glucose [ACPRg]) and disposition index (DI; ×103 mg/kg lean/min), and DXA for body composition. Youth with type 2 diabetes exhibited lower DI (0.6 [0.0, 1.6] vs. 3.8 [2.4, 4.5] × 103 mg/kg lean/min; P < 0.0001) and ACPRg (0.6 [0.3, 1.4] vs. 5.3 [4.3, 6.9] nmol/L; P < 0.001) and higher UACR (10.3 [5.9, 58.0] vs. 5.3 [3.4, 14.3] mg/g; P = 0.003) and intraglomerular pressure (77.8 ± 11.5 vs. 64.8 ± 5.0 mmHg; P < 0.001) compared with OCs. Youth with type 2 diabetes and OCs had higher GFR and kidney oxygen availability (relative hyperoxia) than NWCs. DI was associated inversely with intraglomerular pressure and kidney hyperoxia. Youth with type 2 diabetes demonstrated severe β-cell dysfunction that was associated with intraglomerular hypertension and kidney hyperoxia. Similar but attenuated findings were found in OCs.

Coffee consumption affects kidney function based on GCKR polymorphism in a Korean population

Kidney function can be preserved through pharmacological interventions and nonpharmacological strategies, such as lifestyle and dietary adjustments. Among these, coffee has been linked to protective effects on kidney function. However, few studies have investigated the effect of coffee consumption on kidney function according to specific genes. We hypothesized that the impact of coffee consumption on kidney function might vary depending on GCKR polymorphism. GCKR rs1260326 polymorphism was examined using the Korean genome and epidemiology data from 656 chronic kidney disease (CKD) cases and 38,540 individuals without CKD (non-CKD). GCKR polymorphism has been previously associated with both coffee consumption and kidney function in Europeans. We replicated the associations between GCKR rs1260326 and coffee consumption and kidney function in Korean individuals. We also explored the effect of coffee consumption on kidney function by multivariate logistic regression analysis. Individuals with the rs1260326 (TC/CC) genotype did not experience significant changes in CKD risk based on their coffee consumption habits. In contrast, individuals with the TT genotype exhibited a significantly lower risk of CKD based on coffee consumption. Interestingly, in the non-CKD group, a beneficial effect on estimated glomerular filtration rate was observed in individuals with the T allele as coffee consumption increased. Our findings supported the hypothesis and revealed that the impact of coffee consumption habits on kidney function may vary based on the GCKR rs1260326 genotype of Korean individuals.

FRI633 Financial Benefits Of Renal Dose-adjusted Dipeptidyl Peptidase-4 Inhibitors For Patients With Type 2 Diabetes And Chronic Kidney Disease: A Multicenter Study Utilizing Common Data Model

Abstract Disclosure: H. Choe: None. Y. Ko: None. S. Moon: None. C.H. Ahn: None. K. Ha: None. H. Lee: None. J. Bae: None. H. Joo: None. H. Lee: None. J. Sohn: None. D. Kim: None. S. Kim: None. K. Kim: None. Y. Cho: None. Objective: To estimate the economic benefit of replacing non-renal dose adjusted (NRDA) dipeptidyl peptidase-4 (DPP4) inhibitors with renal dose adjusted (RDA) DPP4 inhibitors in patients with impaired kidney function and type 2 diabetes. Patients and Methods: This multicenter study analyzed a total of 67,964,996 prescription records of five teaching hospitals in Korea from January 1, 2012 to December 31, 2018 using a common data model. Prescription patterns of NRDA and RDA DPP4 inhibitors were subgrouped based on estimated glomerular filtration rate (eGFR) determined by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Results: NRDA DPP4 inhibitors were more frequently prescribed to patients with impaired kidney function than those with preserved kidney function (25.7%, 51.3%, 64.3%, and 71.6% in patients with eGFR of ≥60, &amp;lt;60, &amp;lt;45, and &amp;lt;30 mL/min/1.73m2, respectively). When applying the prescription pattern of DPP4 inhibitors for patients with preserved kidney function to those with impaired kidney function, cost savings per year were 7.6% for eGFR &amp;lt;60 mL/min/1.73m2 and 30.4% for eGFR &amp;lt;30 mL/min/1.73m2. Assuming patients with impaired kidney function are solely prescribed with RDA DPP4 inhibitors with appropriate dose reduction, 15.4% to 51.2% per year could be saved depending on kidney impairment severity. Conclusion: NRDA DPP4 inhibitors are frequently prescribed in patients with type 2 diabetes and CKD. Prescribing RDA DPP4 inhibitors with doses adjusted to individual kidney function could alleviate the economic burden associated with medical expenditure. Presentation: Friday, June 16, 2023

The association between lipid profile, oxidized LDL and the components of metabolic syndrome with serum mineral status and kidney function in individuals with obesity

BackgroundMetabolic syndrome (MetS) is presented with a cluster of cardio-metabolic risk factors with widespread prevalence. In the present case-control study, we aimed to examine the relationship between several minerals and renal function tests with the components of MetS in individuals with obesity.MethodsThis study included 127 individuals with obesity of both gender with or without MetS as the case and control, respectively. MetS was characterized based on the Adult Treatment Panel III (ATP III) criteria. Anthropometric variables and blood pressure were recorded. Mineral status including serum magnesium, copper, calcium, phosphorous, and iron were measured using standard colorimetric methods. Also, the serum lipid levels, concentrations of oxidized low-density lipoprotein (Ox-LDL), and renal function tests, including total protein, albumin, urea, creatinine, and uric acid were evaluated using commercial enzyme-linked immunosorbent assay (ELISA) kits.ResultsAccording to our results, individuals with obesity and MetS had higher levels of waist circumference (WC) and diastolic blood pressure (P < 0.05) compared to individuals with obesity and without MetS. Moreover, individuals with obesity and MetS had higher levels of serum total cholesterol (TC), triglyceride (TG), insulin, and iron (P < 0.05). In individuals with obesity and MetS, iron and albumin showed a positive relationship with LDL cholesterol and TG concentrations, respectively (P < 0.05 for all of them). Also, there was a positive association between serum magnesium and Ox- LDL in individuals with obesity with MetS. While, in individuals with obesity and without MetS, only a positive association between urea and uric acid with WC was observed (P < 0.05).ConclusionOur results suggest that disturbed serum lipids in obesity-metabolic syndrome is associated with homeostatic changes in the level of minerals or proteins that are involved in their metabolism. Although, further studies are needed to better explain and clarify the underlying mechanism of observed relationships.

Mendelian randomization uncovers a protective effect of interleukin-1 receptor antagonist on kidney function

Interleukins (ILs), key cytokine family of inflammatory response, are closely associated with kidney function. However, the causal effect of various ILs on kidney function needs further investigation. Here we show two-sample summary-level Mendelian randomization (MR) analysis that examined the causality between serum IL levels and kidney function. Genetic variants with strong association with serum IL levels were obtained from a previous genome-wide association study meta-analysis. Summary-level data for estimated glomerular filtration rate (eGFR) were obtained from CKDGen database. As a main MR analysis, multiplicative random-effects inverse-variance weighted method was performed. Pleiotropy-robust MR analysis, including MR-Egger with bootstrapped error and weighted median methods, were also implemented. We tested the causal estimates from nine ILs on eGFR traits. Among the results, higher genetically predicted serum IL-1 receptor antagonist level was significantly associated with higher eGFR values in the meta-analysis of CKDGen and the UK Biobank data. In addition, the result was consistent towards eGFR decline phenotype of the outcome database. Otherwise, nonsignificant association was identified between other genetically predicted ILs and eGFR outcome. These findings support the clinical importance of IL-1 receptor antagonist-associated pathway in relation to kidney function in the general individuals, particularly highlighting the importance of IL-1 receptor antagonist.