Elevated bilirubin levels are associated with a better renal prognosis and ameliorate kidney fibrosisReport as inadecuate

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Bilirubin 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.


We 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.


As 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.


Mildly 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.

Author: Sehoon Park , Do Hyoung Kim , Jin Ho Hwang, Yong-Chul Kim, Jin Hyuk Kim, Chun Soo Lim, Yon Su Kim, Seung Hee Yang , Jung Pyo Lee

Source: http://plos.srce.hr/


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