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Urine Osmolality and Renal Outcome in Patients with Chronic Kidney Disease: Results from the KNOW-CKD

DC Field Value Language
dc.contributor.author강신욱-
dc.contributor.author박정탁-
dc.contributor.author유태현-
dc.contributor.author최규헌-
dc.contributor.author한승혁-
dc.date.accessioned2019-12-18T00:39:26Z-
dc.date.available2019-12-18T00:39:26Z-
dc.date.issued2019-
dc.identifier.issn1420-4096-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/173160-
dc.description.abstractBACKGROUND: Urine osmolality indicates the ability of the kidney to concentrate the urine and reflects the antidiuretic action of vasopressin. However, results about the association between urine osmolality and adverse renal outcomes in chronic kidney disease (CKD) are conflicting. We investigated the association between urine osmolality and adverse renal outcomes in a nationwide prospective CKD cohort. METHODS: A total of 1,999 CKD patients were categorized into 3 groups according to their urine osmolality tertiles. Primary outcome was a composite of 50% decline in the estimated glomerular filtration rate (eGFR), initiation of dialysis, or kidney transplantation. RESULTS: During a mean follow-up of 35.2 ± 19.0 months, primary outcome occurred in 432 (21.6%) patients; 240 (36.4%), 162 (24.3%), and 30 (4.5%) in the lowest, middle, and highest tertiles, respectively. Low urine osmolality was independently associated with a greater risk of CKD progression (hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.12-2.59). This association was particularly evident in patients with CKD stages 3-4 (per 10 mosm/kg decrease; HR, 1.02; 95% CI, 1.00-1.03). Adding urine osmolality to a base model with conventional factors significantly increased the ability to predict CKD progression (C-statistics, 0.86; integrated discrimination improvement [IDI], 0.021; both p < 0.001). However, adding both urine osmolality and eGFR did not further improve the predictive ability compared with the addition of eGFR only (C-statistics, p = 0.29; IDI, p = 0.09). CONCLUSIONS: Low urine osmolality was an independent risk factor for adverse renal outcomes in CKD patients, but its predictive ability did not surpass eGFR. Thus, kidney function should be considered while interpreting the clinical significance of urine osmolality.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherKarger-
dc.relation.isPartOfKIDNEY & BLOOD PRESSURE RESEARCH-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleUrine Osmolality and Renal Outcome in Patients with Chronic Kidney Disease: Results from the KNOW-CKD-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorMi Jung Lee-
dc.contributor.googleauthorTae Ik Chang-
dc.contributor.googleauthorJoongyub Lee-
dc.contributor.googleauthorYeong Hoon Kim-
dc.contributor.googleauthorKook-Hwan Oh-
dc.contributor.googleauthorSung Woo Lee-
dc.contributor.googleauthorSoo Wan Kim-
dc.contributor.googleauthorJung Tak Park-
dc.contributor.googleauthorTae-Hyun Yoo-
dc.contributor.googleauthorShin-Wook Kang-
dc.contributor.googleauthorKyu Hun Choi-
dc.contributor.googleauthorCurie Ahn-
dc.contributor.googleauthorSeung Hyeok Han-
dc.identifier.doi10.1159/000502291-
dc.contributor.localIdA00053-
dc.contributor.localIdA01654-
dc.contributor.localIdA02526-
dc.contributor.localIdA04043-
dc.contributor.localIdA04304-
dc.relation.journalcodeJ01940-
dc.identifier.eissn1423-0143-
dc.identifier.pmid31505490-
dc.subject.keywordChronic kidney disease-
dc.subject.keywordEstimated glomerular filtration rate-
dc.subject.keywordOutcome-
dc.subject.keywordUrine osmolality-
dc.contributor.alternativeNameKang, Shin Wook-
dc.contributor.affiliatedAuthor강신욱-
dc.contributor.affiliatedAuthor박정탁-
dc.contributor.affiliatedAuthor유태현-
dc.contributor.affiliatedAuthor최규헌-
dc.contributor.affiliatedAuthor한승혁-
dc.citation.volume44-
dc.citation.number5-
dc.citation.startPage1089-
dc.citation.endPage1100-
dc.identifier.bibliographicCitationKIDNEY & BLOOD PRESSURE RESEARCH, Vol.44(5) : 1089-1100, 2019-
dc.identifier.rimsid63745-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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