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KMID : 1102220230420020251
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Kidney Research and Clinical Practice
2023 Volume.42 No. 2 p.251 ~ p.261
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Association between urinary chloride excretion and progression of coronary artery calcification in patients with nondialysis chronic kidney disease: results from the KNOW-CKD study
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Suh Sang-Heon
Oh Tae-Ryom
Choi Hong-Sang
Kim Chang-Seong
Bae Eun-Hui
Ma Seong-Kwon
Oh Kook-Hwan
Yoo Tae-Hyun
Chae Dong-Wan
KIm Soo-Wan
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Abstract
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Background: Urine chloride has recently been suggested as a biomarker of renal tubule function in patients with nondialysis chronic kidney disease (CKD), as low urinary chloride concentration is associated with an increased risk of CKD progression. We investigate the association between urinary chloride excretion and the progression of coronary artery calcification (CAC).
Methods: A total of 1,065 patients with nondialysis CKD were divided into tertiles by spot urine chloride-to-creatinine ratios. The 1st, 2nd, and 3rd tertiles were defined as low, moderate, and high urinary chloride excretion, respectively. The study outcome was CAC progression, which was defined as an increase in coronary artery calcium score of more than 200 Agatston units during the 4-year follow-up period.
Results: Compared to moderate urinary chloride excretion, high urinary chloride excretion was associated with decreased risk of CAC progression (adjusted odds ratio, 0.379; 95% confidence interval, 0.190?0.757), whereas low urinary chloride excretion was not associated with risk of CAC progression. Restricted cubic spine depicted an inverted J-shaped curve, with a significant reduction in the risk of CAC progression in subjects with high spot urine chloride-to-creatinine ratios.
Conclusion: High urinary chloride excretion is associated with decreased risk of CAC progression in patients with nondialysis CKD.
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KEYWORD
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Biomarkers, Chronic renal insufficiency, Coronary artery disease, Urine chloride
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