TY - JOUR
T1 - Plasma oxalate as a predictor of kidney function decline in a primary hyperoxaluria cohort
AU - Shah, Ronak Jagdeep
AU - Vaughan, Lisa E.
AU - Enders, Felicity T.
AU - Milliner, Dawn S.
AU - Lieske, John C.
N1 - Funding Information:
Funding: This study was supported by the Rare Kidney Stone Consortium (U54KD083908), a part of the Rare Diseases Clinical Research Network (RDCRN), an initiative of the Office of Rare Diseases Research (ORDR), National Center for Advancing Translational Sciences’ (NCATS). This consortium is funded through a collaboration between NCATS and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Oxalosis and Hyperoxaluria Foundation and the Mayo Foundation. Investigators of the RKSC coordinating sites with contributions to the PH Registry include Dean Assimos (University of Alabama, Birmingham), Michelle Baum and Michael Somers (Children’s Hospital, Harvard Medical School), Lawrence Copelovitch (Children’s Hospital of Philadelphia), Prasad Devarajan (Cincinnati Children’s Hospital Medical Center), David Goldfarb (New York University), Elizabeth Harvey and Lisa Robinson (The Hospital for Sick Children [Sickkids], Toronto), William Haley (Mayo Clinic, Jacksonville), Mini Michael (University of Texas) and Craig Langman (Ann & Robert H. Lurie Children’s Memorial Hospital, Chicago).
Funding Information:
This study was supported by the Rare Kidney Stone Consortium (U54KD083908), a part of the Rare Diseases Clinical Research Network (RDCRN), an initiative of the Office of Rare Diseases Research (ORDR), National Center for Advancing Translational Sciences? (NCATS). This consortium is funded through a collaboration between NCATS and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Oxalosis and Hyperoxaluria Foundation and the Mayo Foundation. Investigators of the RKSC coordinating sites with contributions to the PH Registry include Dean Assimos (University of Alabama, Birmingham), Michelle Baum and Michael Somers (Children?s Hospital, Harvard Medical School), Lawrence Copelovitch (Children?s Hospital of Philadelphia), Prasad Devarajan (Cincinnati Children?s Hospital Medical Center), David Goldfarb (New York University), Elizabeth Harvey and Lisa Robinson (The Hospital for Sick Children [Sickkids], Toronto), William Haley (Mayo Clinic, Jacksonville), Mini Michael (University of Texas) and Craig Langman (Ann & Robert H. Lurie Children?s Memorial Hospital, Chicago).
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/5/2
Y1 - 2020/5/2
N2 - This retrospective analysis investigated plasma oxalate (POx) as a potential predictor of end-stage kidney disease (ESKD) among primary hyperoxaluria (PH) patients. PH patients with type 1, 2, and 3, age 2 or older, were identified in the Rare Kidney Stone Consortium (RKSC) PH Registry. Since POx increased with falling estimated glomerular filtration rate (eGFR), patients were stratified by chronic kidney disease (CKD) subgroups (stages 1, 2, 3a, and 3b). POx values were categorized into quartiles for analysis. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for risk of ESKD were estimated using the Cox proportional hazards model with a time-dependent covariate. There were 118 patients in the CKD1 group (nine ESKD events during follow-up), 135 in the CKD 2 (29 events), 72 in CKD3a (34 events), and 45 patients in CKD 3b (31 events). During follow-up, POx Q4 was a significant predictor of ESKD compared to Q1 across CKD2 (HR 14.2, 95% CI 1.8–115), 3a (HR 13.7, 95% CI 3.0–62), and 3b stages (HR 5.2, 95% CI 1.1–25), p < 0.05 for all. Within each POx quartile, the ESKD rate was higher in Q4 compared to Q1–Q3. In conclusion, among patients with PH, higher POx concentration was a risk factor for ESKD, particularly in advanced CKD stages.
AB - This retrospective analysis investigated plasma oxalate (POx) as a potential predictor of end-stage kidney disease (ESKD) among primary hyperoxaluria (PH) patients. PH patients with type 1, 2, and 3, age 2 or older, were identified in the Rare Kidney Stone Consortium (RKSC) PH Registry. Since POx increased with falling estimated glomerular filtration rate (eGFR), patients were stratified by chronic kidney disease (CKD) subgroups (stages 1, 2, 3a, and 3b). POx values were categorized into quartiles for analysis. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for risk of ESKD were estimated using the Cox proportional hazards model with a time-dependent covariate. There were 118 patients in the CKD1 group (nine ESKD events during follow-up), 135 in the CKD 2 (29 events), 72 in CKD3a (34 events), and 45 patients in CKD 3b (31 events). During follow-up, POx Q4 was a significant predictor of ESKD compared to Q1 across CKD2 (HR 14.2, 95% CI 1.8–115), 3a (HR 13.7, 95% CI 3.0–62), and 3b stages (HR 5.2, 95% CI 1.1–25), p < 0.05 for all. Within each POx quartile, the ESKD rate was higher in Q4 compared to Q1–Q3. In conclusion, among patients with PH, higher POx concentration was a risk factor for ESKD, particularly in advanced CKD stages.
KW - Chronic kidney disease
KW - End-stage renal disease
KW - Estimated glomerular filtration rate
KW - Plasma oxalate
KW - Primary hyperoxaluria
KW - Urine Oxalate
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UR - http://www.scopus.com/inward/citedby.url?scp=85085265443&partnerID=8YFLogxK
U2 - 10.3390/ijms21103608
DO - 10.3390/ijms21103608
M3 - Article
C2 - 32443777
AN - SCOPUS:85085265443
SN - 1661-6596
VL - 21
JO - International journal of molecular sciences
JF - International journal of molecular sciences
IS - 10
M1 - 3608
ER -