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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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-81332-2 |
| _version_ | 1818436043076009984 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-14T17:02:30Z |
| format | Article |
| id | doaj.art-ea8f906bcd71473c9affe906c9e54fde |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T17:02:30Z |
| publishDate | 2021-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-ea8f906bcd71473c9affe906c9e54fde2022-12-21T22:53:49ZengNature PortfolioScientific Reports2045-23222021-01-011111910.1038/s41598-021-81332-2Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinicKyung Don Yoo0Jung Nam An1Yong Chul Kim2Jeonghwan Lee3Kwon-Wook Joo4Yun Kyu Oh5Yon Su Kim6Chun Soo Lim7Sohee Oh8Jung Pyo Lee9Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of MedicineDepartment of Internal Medicine, Hallym University Sacred Heart HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University Boramae Medical CenterDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University Boramae Medical CenterDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University Boramae Medical CenterDepartment of Biostatistics, Seoul National University Boramae Medical CenterDepartment of Internal Medicine, Seoul National University Boramae Medical CenterAbstract 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.https://doi.org/10.1038/s41598-021-81332-2 |
| spellingShingle | 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 Scientific Reports |
| title | 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_short | 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 |
| url | https://doi.org/10.1038/s41598-021-81332-2 |
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