Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Renji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China.
State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200032, China.
Int Urol Nephrol. 2024 Nov;56(11):3665-3677. doi: 10.1007/s11255-024-04119-0. Epub 2024 Jun 19.
Chloride, the predominant anion in extracellular fluid from humans, is essential to maintaining homeostasis. One important metric for thoroughly assessing kidney function is the estimated glomerular filtration rate (eGFR). However, the relationship between variations in serum chloride concentration and eGFR in general populations has been poorly studied. Therefore, the purpose of this study is to elucidate the correlation between serum chloride levels and eGFR within the United States' adult population.
This cohort study was conducted using data from the National Health and Nutrition Examination Survey (NHANES), which covered the years 1999-2018. We employed multiple linear regression analysis and subgroup analysis to evaluate the correlation between serum chloride concentration and eGFR. To examine the nonlinear association between serum chloride levels and eGFR, restricted cubic spline analyses were employed.
Data from 49,008 participants in this cohort study were used for the chloride analysis. In the comprehensively adjusted model, a noteworthy inverse relationship was discovered between chloride plasma concentration and eGFR. Restricted cubic spline analyses revealed a significant nonlinear relationship between chloride levels and eGFR (P for overall < 0.001 and P for nonlinear < 0.001). A significant interaction was observed between eGFR and plasma chloride concentration (all P < 0.001 for interaction) among the subgroups characterized by sex, household income to poverty ratio, BMI, hypertension, and diabetes.
Our findings suggest that higher levels of chloride plasma concentration were linked to decreased eGFR. These findings underscore the significance of monitoring chloride plasma concentration as a potential indicator for identifying individuals at risk of developing chronic kidney disease (CKD).
氯离子是人类细胞外液中的主要阴离子，对维持体内平衡至关重要。评估肾功能的一个重要指标是估算肾小球滤过率（eGFR）。然而，一般人群中血清氯离子浓度与 eGFR 之间的关系尚未得到充分研究。因此，本研究旨在阐明美国成年人群中血清氯离子水平与 eGFR 之间的相关性。
本队列研究使用了 1999 年至 2018 年国家健康和营养检查调查（NHANES）的数据。我们采用多元线性回归分析和亚组分析来评估血清氯离子浓度与 eGFR 之间的相关性。为了检验血清氯离子水平与 eGFR 之间的非线性关系，我们采用了受限立方样条分析。
本队列研究共有 49008 名参与者的数据用于氯离子分析。在综合调整模型中，发现氯离子血浆浓度与 eGFR 之间存在显著的负相关关系。受限立方样条分析显示，氯离子水平与 eGFR 之间存在显著的非线性关系（总体 P<0.001，非线性 P<0.001）。在按性别、家庭收入与贫困比率、BMI、高血压和糖尿病划分的亚组中，均观察到 eGFR 与血浆氯离子浓度之间存在显著的交互作用（交互作用的所有 P 值均<0.001）。
我们的研究结果表明，较高的氯离子血浆浓度与 eGFR 降低有关。这些发现强调了监测氯离子血浆浓度作为识别慢性肾脏病（CKD）风险人群的潜在指标的重要性。
