Background. Research data are limited about indices of osmotic equilibrium and of kidney concentrating activity. This study investigated correlates and prognostic power of these indices in a sample of the general population. Methods. Urine osmolality (U-osm), plasma osmolality (P-osm), plasma creatinine, and other variables were measured by Gubbio Study for the 1988-92 exam (baseline). Plasma creatinine and other variables were re-measured in 2001-07 (follow-up). Kidney concentrating activity was assessed as U-osm/P-osm ratio and kidney function as estimated glomerular filtration rate (eGFR). Results. Baseline data were complete in 4220 adults of whom 852 dead before follow-up and 2795 participated in follow-up. At baseline, there were the following independent cross-sectional associations: female sex and higher urine flow with lower values of U-osm, P-osm, and U-osm/P-osm ratio (P<0.01); obesity with higher values of U-osm, P-osm, and U-osm/P-osm ratio (P<0.01); older age and lower eGFR with lower U-osm, lower U-osm/P-osm ratio, and higher P-osm (P<0.05); hypertension and smoking with lower U-osm and lower U-osm/P-osm ratio (P<0.05) but not with P-osm. From baseline to follow-up, annualized rate was 1.26% for mortality and -0.74±0.76 mL/min x 1.73 m2 for eGFR change. Mortality was independently predicted by baseline U-osm and baseline U-osm/P-osm ratio (hazard ratio for one higher SD ≤0.91, 95% confidence interval ≤0.97, P< 0.01), but not by baseline P-osm. eGFR change was not independently predicted by baseline values of U-osm, P-osm, and U-osm/P-osm ratio (P≥0.4). Conclusions. Sex, age, obesity, eGFR, urine flow, hypertension, and smoking independently correlated with U-osm and kidney concentrating activity. U-osm and kidney concentrating activity independently predicted mortality, but not kidney function change over time.
OSMOTIC INDICES AND KIDNEY CONCENTRATING ACTIVITY: POPULATION-BASED DATA ABOUT CORRELATES AND PROGNOSTIC POWER
CIRILLO, Massimo
;Bilancio, Giancarlo;CAVALLO, Pierpaolo;
2018-01-01
Abstract
Background. Research data are limited about indices of osmotic equilibrium and of kidney concentrating activity. This study investigated correlates and prognostic power of these indices in a sample of the general population. Methods. Urine osmolality (U-osm), plasma osmolality (P-osm), plasma creatinine, and other variables were measured by Gubbio Study for the 1988-92 exam (baseline). Plasma creatinine and other variables were re-measured in 2001-07 (follow-up). Kidney concentrating activity was assessed as U-osm/P-osm ratio and kidney function as estimated glomerular filtration rate (eGFR). Results. Baseline data were complete in 4220 adults of whom 852 dead before follow-up and 2795 participated in follow-up. At baseline, there were the following independent cross-sectional associations: female sex and higher urine flow with lower values of U-osm, P-osm, and U-osm/P-osm ratio (P<0.01); obesity with higher values of U-osm, P-osm, and U-osm/P-osm ratio (P<0.01); older age and lower eGFR with lower U-osm, lower U-osm/P-osm ratio, and higher P-osm (P<0.05); hypertension and smoking with lower U-osm and lower U-osm/P-osm ratio (P<0.05) but not with P-osm. From baseline to follow-up, annualized rate was 1.26% for mortality and -0.74±0.76 mL/min x 1.73 m2 for eGFR change. Mortality was independently predicted by baseline U-osm and baseline U-osm/P-osm ratio (hazard ratio for one higher SD ≤0.91, 95% confidence interval ≤0.97, P< 0.01), but not by baseline P-osm. eGFR change was not independently predicted by baseline values of U-osm, P-osm, and U-osm/P-osm ratio (P≥0.4). Conclusions. Sex, age, obesity, eGFR, urine flow, hypertension, and smoking independently correlated with U-osm and kidney concentrating activity. U-osm and kidney concentrating activity independently predicted mortality, but not kidney function change over time.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
