The Effect of Cadmium on GFR Is Clarified by Normalization of Excretion Rates to Creatinine Clearance
| Autor: | Kenneth R. Phelps, Muneko Nishijo, David A. Vesey, Soisungwan Satarug, Werawan Ruangyuttikarn, Glenda C. Gobe |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
genetic structures 030232 urology & nephrology Urine 010501 environmental sciences urologic and male genital diseases 01 natural sciences lcsh:Chemistry 0302 clinical medicine lcsh:QH301-705.5 Spectroscopy Aged 80 and over Cadmium integumentary system Chemistry nephrotoxicity hemic and immune systems General Medicine Middle Aged Computer Science Applications Kidney Tubules Creatinine Female hormones hormone substitutes and hormone antagonists Glomerular Filtration Rate Normalization (statistics) Adult medicine.medical_specialty Adolescent cadmium N-acetyl-β-D-glucosaminidase Urology chemistry.chemical_element Renal function Catalysis Article GFR Nephrotoxicity Inorganic Chemistry Excretion 03 medical and health sciences Young Adult Acetylglucosaminidase medicine Humans Physical and Theoretical Chemistry Renal Insufficiency Chronic Molecular Biology 0105 earth and related environmental sciences Aged urine creatinine urogenital system Organic Chemistry fungi Environmental Exposure Urine Creatinine medicine.disease excretion rate lcsh:Biology (General) lcsh:QD1-999 chronic kidney disease Kidney disease |
| Zdroj: | International Journal of Molecular Sciences Volume 22 Issue 4 International Journal of Molecular Sciences, Vol 22, Iss 1762, p 1762 (2021) |
| ISSN: | 1422-0067 |
| DOI: | 10.3390/ijms22041762 |
| Popis: | Erroneous conclusions may result from normalization of urine cadmium and N-acetyl-β-D-glucosaminidase concentrations ([Cd]u and [NAG]u) to the urine creatinine concentration ([cr]u). In theory, the sources of these errors are nullified by normalization of excretion rates (ECd and ENAG) to creatinine clearance (Ccr). We hypothesized that this alternate approach would clarify the contribution of Cd-induced tubular injury to nephron loss. We studied 931 Thai subjects with a wide range of environmental Cd exposure. For x = Cd or NAG, Ex/Ecr and Ex/Ccr were calculated as [x]u/[cr]u and [x]u[cr]p/[cr]u, respectively. Glomerular filtration rate (GFR) was estimated according to the Chronic Kidney Disease (CKD) Epidemiology Collaboration (eGFR), and CKD was defined as eGFR < 60 mL/min/1.73m2. In multivariable logistic regression analyses, prevalence odds ratios (PORs) for CKD were higher for log(ECd/Ccr) and log(ENAG/Ccr) than for log(ECd/Ecr) and log(ENAG/Ecr). Doubling of ECd/Ccr and ENAG/Ccr increased POR by 132% and 168% doubling of ECd/Ecr and ENAG/Ecr increased POR by 64% and 54%. As log(ECd/Ccr) rose, associations of eGFR with log(ECd/Ccr) and log(ENAG/Ccr) became stronger, while associations of eGFR with log(ECd/Ecr) and log(ENAG/Ecr) became insignificant. In univariate regressions of eGFR on each of these logarithmic variables, R2 was consistently higher with normalization to Ccr. Our tabular and graphic analyses uniformly indicate that normalization to Ccr clarified relationships of ECd and ENAG to eGFR. |
| Databáze: | OpenAIRE |
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