ArticlePloS one2017
Elevated bilirubin levels are associated with a better renal prognosis and ameliorate kidney fibrosis.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 25 citations in OpenAlex.
- Bilirubin levels and kidney function decline: An analysis of clinical trial and real world data.PloS one · 2022Trial
- Association of Hyperbilirubinemia with Lipid Profile and Lipid-Related Diseases: A Large Community-Based Cohort Study.Journal of clinical medicine · 2026Article
- Serum bilirubin concentrations in peritoneal dialysis patients are correlated with the initial onset of peritonitis.BMC nephrology · 2025Article
- Field direction of static magnetic fields influences kidney fibrosis progression through MAPK signaling and cell cycle alteration.Scientific reports · 2025Article
- Association between the total bilirubin to prothrombin time ratio index and diabetic retinopathy, nephropathy, peripheral neuropathy, and foot disease: a retrospective study and risk prediction model construction.Frontiers in endocrinology · 2025Article
- Association between bilirubin and chronic kidney disease in hypertensive patients: The China hypertension registry study.Journal of clinical hypertension (Greenwich, Conn.) · 2023Article
- Associations between liver function parameters and poor clinical outcomes in peritoneal dialysis patients.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2023Review
- Serum bilirubin and kidney function: a Mendelian randomization study.Clinical kidney journal · 2022Article
- Translational Approach to the Protective Effect of Bilirubin in Diabetic Kidney Disease.Biomedicines · 2022Review
- Serum bilirubin as a predictor of graft outcomes after renal transplant.American journal of clinical and experimental urology · 2022Article
- Lower serum bilirubin is associated with poor renal outcome in IgA nephropathy patients.International journal of medical sciences · 2021Observational
- Article
- Non-urate transporter 1, non-glucose transporter member 9-related renal hypouricemia and acute renal failure accompanied by hyperbilirubinemia after anaerobic exercise: a case report.BMC nephrology · 2019Article
- Beyond a Measure of Liver Function-Bilirubin Acts as a Potential Cardiovascular Protector in Chronic Kidney Disease Patients.International journal of molecular sciences · 2018Review
- Hyperbilirubinemia, Hypertension, and CKD: the Links.Current hypertension reports · 2017Review
- Correlation between serum bilirubin levels and the severity as well as the prognosis of idiopathic pulmonary fibrosis.Chronic respiratory diseaseArticle
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBilirubin has been reported to protect against kidney injury. However, further studies highlighting the beneficial effects of bilirubin on renal fibrosis and chronic renal function decline are necessary.
methodsWe assessed a prospective cohort with a reference range of total bilirubin levels. The primary outcome was a 30% reduction in the estimated glomerular filtration rate (eGFR) from baseline, and the secondary outcome was a doubling of the serum creatinine levels, halving of the eGFR and the initiation of dialysis. In addition, experiments with tubular epithelial cells and C57BL/6 mice were performed to investigate the protective effects of bilirubin on kidney fibrosis.
resultsAs a result, 1,080 patients were included in the study cohort. The study group with relative hyperbilirubinemia (total bilirubin 0.8-1.2 mg/dL) showed a better prognosis in terms of the primary outcome (adjusted hazard ratio (HR) 0.33, 95% confidence interval (CI) 0.19-0.59, P < 0.001) and the secondary outcome (adjusted HR 0.20, 95% CI 0.05 to 0.71, P = 0.01) than that of the control group. Moreover, the bilirubin-treated mice showed less fibrosis in the unilateral ureteral obstruction (UUO) model (P < 0.05). In addition, bilirubin treatment decreased fibronectin expression in tubular epithelial cells in a dose-dependent manner (P < 0.05).
conclusionsMildly elevated serum bilirubin levels were associated with better renal prognosis, and bilirubin treatment induced a beneficial effect on renal fibrosis. Therefore, bilirubin could be a potential therapeutic target to delay fibrosis-related kidney disease progression.
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