Serum bilirubin association with estimated glomerular filtration rate and other risk factors in the progression of chronic kidney disease among CKD patients: A Hospital-based cross sectional study design

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Abstract Background Chronic kidney disease is one of the most serious public health burdens globally, with significant morbidity, mortality, and reduced in patient life expectancy. Although the current marker of kidney disease is the glomerular filtration rate (GFR), the serum creatinine used for GFR determination is influenced by many factors. Therefore, it has become increasingly important to search for possible additional parameters related to estimated glomerular filtration rate to enhance early detection of disease progression. This study aims to evaluate serum bilirubin parameter and its correlation with eGFR in the progression of chronic kidney disease among CKD patients on follow-up at Jimma University Medical Center. Method A hospital-based cross-sectional study was conducted at Jimma University Medical Center from November 5 to January 13, 2022. Using consecutive sampling technique, a total of 140 CKD follow-up patients were recruited into the current study. Data were collected using interviewer-based structured questionnaires, record reviews, and physical examinations. Data were analyzed by SPSS version 25.0. The correlation between eGFR as well as other explanatory variables with serum bilirubin (total and direct) concentrations was examined by Pearson’s correlation analyses. Univariate and multivariate linear regression were used to test predictors of serum bilirubin (total and direct bilirubin) in the study participants. Results A total of 140 study participants were recruited for this study. Subjects included (54.3% [n = 76]) men and (45.7% [n = 64]) women, respectively. The mean (SD) age of study subjects was 51.04 ± 9.02 years with a minimum and maximum age of being 30 and 70 years old, respectively. A positive correlation was found between serum bilirubin and eGFR; total bilirubin(r = 0.868, P < 0.001), direct bilirubin (r = 0.641, P < 0.001). BMI was negatively correlated (r=-0.221, P < 0.009) with serum bilirubin value. Moreover, the eGFR value was positively associated (β = 0.04, P = < 0.001) with serum total bilirubin among study participants. Conclusion According to the results of the current study, estimated glomerular filtration rate were positively correlated with both serum total and direct bilirubin. Furthermore, eGFR was positively associated with serum total and direct bilirubin in the study subjects, whereas BMI was negatively associated with serum bilirubin in CKD participants. Therefore, low serum bilirubin (total and direct bilirubin) and increased body mass index are independent risk factors for disease progression in patients with CKD.

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