Serum Bilirubin Concentrations and Chronic Kidney Disease



The association between serum bilirubin concentrations and CKD is controversial and conflicting studies show opposing results. This study as presented in the slideshow, shows that higher serum direct bilirubin levels were significantly associated with a lower risk of the development of CKD, even when considering a variety of cardiometabolic parameters. The study authors believe that serum direct bilirubin could become a new marker for assessing CKD risk and a potential target for risk modification. Published February 20, 2014 PLOS One

A number of cross-sectional studies indicate a positive association between serum total bilirubin concentration and estimated glomerular filtration rate (eGFR).  One retrospective study showed higher serum bilirubin concentrations are associated with lower risk of contrast-induced nephropathy and fewer cardiovascular events in the patients with angina pectoris or acute myocardial infarction. However, two other studies  found that higher bilirubin concentrations were significantly associated with lower eGFR both in hospital-based unselected outpatients and in the US general population. The goal of this longitudinal study was to evaluate the evaluate the prospective association between bilirubin concentration (total, direct, and indirect) and the risk for CKD.