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Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic

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Abstract
Large-scale studies have not been conducted to assess whether serum hypobicarbonatemia increases the risk for kidney function deterioration and mortality among East-Asians. We aimed to determine the association between serum total CO2 (TCO2) concentrations measured at the first outpatient visit and clinical outcomes. In this multicenter cohort study, a total of 42,231 adult nephrology outpatients from 2001 to 2016 were included. End-stage renal disease (ESRD) patients on dialysis within 3 months of the first visit were excluded. Instrumental variable (IV) was used to define regions based on the proportion of patients with serum TCO2<22 mEq/L. The crude mortality rate was 12.2% during a median 77.0-month follow-up period. The Cox-proportional hazard regression model adjusted for initial kidney function, alkali supplementation, and the use of diuretics demonstrated that low TCO2 concentration was not associated with progression to ESRD, but significantly increased the risk of death. The IV analysis also confirmed a significant association between initial TCO2 concentration and mortality (HR 0.56; 95% CI 0.49-0.64). This result was consistently significant regardless of the underlying renal function. In conclusion, low TCO2 levels are significantly associated with mortality but not with progression to ESRD in patients with ambulatory care.
Author(s)
김연수김용철안정남오소희오윤규유경돈이정표이정환임춘수주권욱
Issued Date
2021
Type
Article
Keyword
Ambulatory careCarbon dioxideDiureticsEnd-stage renal diseaseHealth careKidney diseasesKidneysMedical researchMortalityNephrologyRenal functionRisk factorsSupplementation
DOI
10.1038/s41598-021-81332-2
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7023
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_ea8f906bcd71473c9affe906c9e54fde&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Low%20serum%20total%20CO2%20and%20its%20association%20with%20mortality%20in%20patients%20being%20followed%20up%20in%20the%20nephrology%20outpatients%20clinic&amp;offset=0&amp;pcAvailability=true
Publisher
SCIENTIFIC REPORTS
Location
미국
Language
영어
ISSN
2045-2322
Citation Volume
11
Citation Number
1
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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