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

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 v...

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Autores principales:	Kyung Don Yoo, Jung Nam An, Yong Chul Kim, Jeonghwan Lee, Kwon-Wook Joo, Yun Kyu Oh, Yon Su Kim, Chun Soo Lim, Sohee Oh, Jung Pyo Lee
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ea8f906bcd71473c9affe906c9e54fde
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spelling	oai:doaj.org-article:ea8f906bcd71473c9affe906c9e54fde2021-12-02T13:51:05ZLow serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic10.1038/s41598-021-81332-22045-2322https://doaj.org/article/ea8f906bcd71473c9affe906c9e54fde2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81332-2https://doaj.org/toc/2045-2322Abstract 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.Kyung Don YooJung Nam AnYong Chul KimJeonghwan LeeKwon-Wook JooYun Kyu OhYon Su KimChun Soo LimSohee OhJung Pyo LeeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kyung Don Yoo Jung Nam An Yong Chul Kim Jeonghwan Lee Kwon-Wook Joo Yun Kyu Oh Yon Su Kim Chun Soo Lim Sohee Oh Jung Pyo Lee Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic
description	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.
format	article
author	Kyung Don Yoo Jung Nam An Yong Chul Kim Jeonghwan Lee Kwon-Wook Joo Yun Kyu Oh Yon Su Kim Chun Soo Lim Sohee Oh Jung Pyo Lee
author_facet	Kyung Don Yoo Jung Nam An Yong Chul Kim Jeonghwan Lee Kwon-Wook Joo Yun Kyu Oh Yon Su Kim Chun Soo Lim Sohee Oh Jung Pyo Lee
author_sort	Kyung Don Yoo
title	Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic
title_short	Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic
title_full	Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic
title_fullStr	Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic
title_full_unstemmed	Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic
title_sort	low serum total co2 and its association with mortality in patients being followed up in the nephrology outpatients clinic
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ea8f906bcd71473c9affe906c9e54fde
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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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