Kidney Res Clin Pract > Volume 40(1); 2021 > Article |
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Funding
This study was supported by the Young Investigator Research Grant from the Korean Nephrology Research Foundation (2019).
Authors’ contributions
Conceptualization: JHJ, SHA
Data curation: JHJ
Formal analysis: JHJ, MMK, SHA
Funding acquisition: JHJ
Investigation: JHJ, SHA, JHS
Methodology: JHJ, SHA
Project administration: JHJ, SHA, JHS
Visualization: JHJ, MMK, SHA
Writing–original draft: JHJ, SHA
Writing–review & editing: JHJ, SHA, MMK, JHS
All authors read and approved the final manuscript.
Characteristic | Control group | MCO group | p-value |
---|---|---|---|
No. of patients | 18 | 16 | - |
Sex, male:female | 13:5 | 9:7 | 0.180 |
Age (yr) | 55.00 ± 7.57 | 47.88 ± 12.03 | 0.043* |
HD duration (mo) | 35.00 (12.00–66.25) | 36.00 (27.00–65.50) | 0.557a |
Frequency/wk | |||
2 | 1 (5.6) | 1 (6.3) | 0.999b |
3 | 17 (94.4) | 15 (93.8) | |
Hypertension | 17 (94.4) | 14 (87.5) | 0.591b |
Diabetes mellitus | 13 (72.2) | 9 (56.3) | 0.331 |
Cv Cx | 4 (22.2) | 3 (18.8) | >0.999b |
Cause | |||
DMN | 13 | 9 | 0.454 |
HN | 4 | 4 | |
CGN | 0 | 2 | |
PCKD | 1 | 1 | |
Lab parameter | |||
PTH (pg/mL) | 120.80 (68.46–255.30) | 153.45 (102.20–317.95) | 0.512a |
CRP (mg/L) | 2.03 (0.87–3.57) | 1.22 (0.64–10.28) | 0.769a |
Albumin (g/dL) | 3.80 ± 0.22 | 4.07 ± 0.28 | 0.004* |
Total protein (g/dL) | 6.51 ± 0.44 | 6.80 ± 0.42 | 0.069 |
Hemoglobin (g/dL) | 10.31 ± 0.83 | 10.94 ± 1.73 | 0.237 |
Calcium (mg/dL) | 9.22 ± 0.64 | 9.21 ± 0.64 | 0.877 |
Phosphate (mg/dL) | 4.82 ± 1.46 | 6.31 ± 2.20 | 0.030* |
spKt/V | 1.46 ± 0.18 | 1.47 ± 0.27 | 0.950 |
FTI (kg/m2) | 9.14 ± 4.75 | 9.92 ± 3.48 | 0.263 |
LTI (kg/m2) | 14.05 ± 2.47 | 14.56 ± 2.78 | 0.619 |
OH (%ECW) | 17.63 ± 9.21 | 10.26 ± 11.22 | 0.030* |
GDF15 (pg/mL) | 8,043.43 ± 3,491.54 | 5,245.67 ± 1,426.06 | 0.080 |
Leptin (pg/mL) | 21,172.57 ± 25,480.09 | 18,146.72 ± 28,050.34 | 0.506a |
Sclerostin (pg/mL) | 9,606.6 ± 2,998.6 | 8,227.2 ± 3,082.9 | 0.322 |
FGF23 (pg/mL) | 597.40 ± 405.35 | 1,294.05 ± 906.97 | 0.065 |
RBP4 (ng/mL) | 66,522.00 ± 10,296.59 | 63,412.12 ± 13,115.55 | 0.582 |
β2MG (ng/mL) | 75,787.14 ± 32,591.76 | 97,553.53 ± 70,029.65 | 0.727a |
Data are expressed as number only, mean ± standard deviation, median (interquartile range), or number (%).
HD, hemodialysis; CGN, chronic glomerulonephropathy; CRP, C-reactive protein; Cv Cx, cardiovascular complications; DMN, diabetic nephropathy; ECW, extracellular water; FGF23, fibroblast growth factor 23; FTI, fat tissue index; GDF15, growth differentiation factor 15; HN, hypertensive nephropathy; LTI, lean tissue index; MCO, medium cut-off; OH, overhydration; PCKD, polycystic kidney disease; PTH, parathyroid hormone; RBP4, retinol-binding protein 4; spKt/V, single-pool Kt/V; β2MG, beta-2 microglobulin.
Variable | Time from baseline (mo) |
Mean change (95% CI) |
p-value within controla | p-value within MCOa | Adjusted mean difference between the groups (95% CI)c | p-value between groupsd | |
---|---|---|---|---|---|---|---|
Control group | MCO group | ||||||
Phosphate (mg/dL) | 3 | –0.178 (–0.835 to 0.477) | –0.406 (–1.821 to 1.009) | 0.574 | 0.550 | 0.969 (–0.291 to 2.228) | 0.127 |
6 | 0.553 (–0.243 to 1.349) | –0.206 (–1.126 to 0.714) | 0.162 | 0.640 | –0.202 (–1.406 to 1.002) | 0.734 | |
9 | –0.042 (–0.698 to 0.613) | –0.200 (–1.293 to 0.893) | 0.894 | 0.702 | 0.556 (–0.597 to 1.709) | 0.333 | |
12 | 0.642 (–0.089 to 1.374) | –0.463 (–1.370 to 0.445) | 0.082 | 0.294 | –0.572 (–1.472 to 0.328) | 0.204 | |
Calcium (mg/dL) | 3 | –0.090 (–0.350 to 0.171) | –0.088 (–0.378 to 0.203) | 0.479 | 0.531 | –0.135 (–0.476 to 0.205) | 0.423 |
6 | –0.353 (–0.745 to 0.040) | –0.169 (–0.478 to 0.140) | 0.075 | 0.262 | 0.097 (–0.297 to 0.492) | 0.619 | |
9 | –0.526 (–0.858 to –0.195) | –0.656 (–0.936 to –0.377) | 0.004* | <0.001* | –0.198 (–0.513 to 0.117) | 0.210 | |
12 | –0.547 (–0.854 to –0.241) | –0.594 (–0.929 to –0.258) | 0.001* | 0.002* | –0.011 (–0.426 to 0.405) | 0.958 | |
Hemoglobin (g/dL) | 3 | –0.142 (–0.658 to 0.374) | –0.425 (–0.961 to 0.111) | 0.570 | 0.121b | –0.134 (–0.941 to 0.672) | 0.736 |
6 | 0.058 (–0.415 to 0.531) | –0.331 (–1.376 to 0.714) | 0.800 | 0.510 | –0.161 (–1.033 to 0.712) | 0.709 | |
9 | 0.016 (–0.377 to 0.408) | –0.594 (–1.292 to 0.105) | 0.844b | 0.090 | –0.502 (–1.211 to 0.207) | 0.158 | |
12 | 0.047 (–0.300 to 0.394) | –0.344 (–1.135 to 0.447) | 0.938b | 0.369 | 0.092 (–0.567 to 0.752) | 0.777 | |
Total protein | 3 | –0.089 (–0.272 to 0.094) | –0.344 (–0.526 to –0.161) | 0.318 | 0.001* | –0.191 (–0.478 to 0.097) | 0.186 |
(g/dL) | 6 | –0.121 (–0.291 to 0.049) | –0.281 (–0.489 to –0.073) | 0.153 | 0.011* | –0.063 (–0.351 to 0.226) | 0.660 |
9 | 0.032 (–0.203 to 0.266) | –0.350 (–0.569 to –0.131) | 0.721 | 0.004* | –0.263 (–0.619 to 0.092) | 0.141 | |
12 | –0.111 (–0.297 to 0.077) | –0.288 (–0.506 to –0.069) | 0.231 | 0.013* | –0.052 (–0.361 to 0.257) | 0.734 | |
Albumin | 3 | –0.090 (–0.248 to 0.069) | –0.313 (–0.431 to –0.194) | 0.250 | <0.001* | –0.102 (–0.318 to 0.115) | 0.345 |
(g/dL) | 6 | –0.163 (–0.295 to –0.031) | –0.356 (–0.490 to –0.223) | 0.018* | <0.001* | –0.127 (–0.332 to 0.078) | 0.217 |
9 | 0.063 (–0.072 to 0.199) | –0.200 (–0.353 to –0.047) | 0.341 | 0.014* | –0.137 (–0.350 to 0.075) | 0.197 | |
12 | 0.095 (–0.051 to 0.241) | –0.138 (–0.295 to 0.020) | 0.189 | 0.083 | –0.147 (–0.382 to 0.087) | 0.210 | |
LTI (kg/m2) | 3 | –0.032 (–0.590 0.527) | –0.475 (–1.317 to 0.367) | 0.907 | 0.248 | –0.162 (–1.134 to 0.810) | 0.736 |
6 | –0.084 (–0.988 to 0.819) | –0.881 (–1.454 to –0.309) | 0.847 | 0.005 | –0.538 (–1.626 to 0.550) | 0.321 | |
9 | –0.369 (–1.080 to 0.343) | –0.150 (–1.292 to 0.992) | 0.287 | 0.783 | –0.118 (–1.546 to 1.309) | 0.866 | |
12 | –0.650 (–1.360 to 0.060) | –0.744 (–1.492 to 0.005) | 0.070 | 0.066 | –0.216 (–1.270 to 0.838) | 0.679 | |
FTI (kg/m2) | 3 | 38.316 (–41.659 to 118.291) | 0.294 (–0.525 to 1.112) | 0.334b | 0.456 | –39.005 (–135.068 to 57.057) | 0.414 |
6 | 1.232 (0.367 to 2.097) | 0.969 (0.117 to 1.820) | 0.008* | 0.028* | –0.219 (–1.564 to 1.126) | 0.742 | |
9 | 0.394 (–0.728 to 1.515) | –0.031 (–1.662 to 1.599) | 0.466 | 0.679b | –0.048 (–2.100 to 2.004) | 0.962 | |
12 | 0.883 (0.147 to 1.620) | 0.981 (0.150 to 1.813) | 0.022* | 0.024* | 0.447 (–0.701 to 1.595) | 0.432 | |
OH (%ECW) | 3 | 1.668 (–0.788 to 4.125) | 1.319 (–3.362 to 5.999) | 0.171 | 0.557 | –2.424 (–7.076 to 2.229) | 0.296 |
6 | –1.758 (–5.512 to 1.996) | 0.681 (–5.431 to 6.793) | 0.338 | 0.815 | –1.448 (–7.945 to 5.048) | 0.652 | |
9 | –2.494 (–6.528 to 1.540) | 0.213 (–5.425 to 5.850) | 0.207 | 0.937 | 1.048 (–5.157 to 7.253) | 0.732 | |
12 | –0.842 (–4.936 to 3.252) | 3.125 (–3.382 to 9.632) | 0.671 | 0.163b | –0.343 (–6.270 to 5.584) | 0.907 | |
spKt/V | 3 | 0.022 (–0.057 to 0.102) | 0.092 (0.001 to 0.183) | 0.567 | 0.048* | 0.022 (–0.097 to 0.140) | 0.712 |
6 | –0.009 (–0.086 to 0.068) | 0.115 (0.015 to 0.215) | 0.808 | 0.027 | 0.096 (–0.033 to 0.226) | 0.140 | |
9 | 0.011 (–0.054 to 0.075) | 0.046 (–0.030 to 0.123) | 0.729 | 0.217 | 0.025 (–0.084 to 0.134) | 0.645 | |
12 | –0.015 (–0.081 to 0.052) | 0.069 (–0.123 to 0.150) | 0.639 | 0.041 | 0.068 (–0.040 to 0.176) | 0.206 | |
PTH (pg/mL) | 3 | 36.647 (–11.606 to 84.901) | 102.893 (–17.732 to 223.519) | 0.136b | 0.089b | 46.133 (–50.287 to 142.554) | 0.336 |
6 | 30.532 (–17.47078.533) | 38.051 (–56.785 to 132.888) | 0.198 | 0.406 | 0.281 (–109.516 to 110.077) | 0.996 | |
9 | 73.682 (–3.298 to 150.662) | 162.109 (–75.383 to 399.602) | 0.077b | 0.166b | 76.267 (–138.308 to 290.843) | 0.474 | |
12 | 124.428 (6.765 to 242.093) | 163.216 (–33.050 to 359.481) | 0.001b,* | 0.097b | –28.583 (–221.617 to 164.451) | 0.764 | |
CRP (mg/L) | 3 | –1.479 (–2.872 to –0.086) | 1.503 (–4.874 to 7.880) | 0.039 | 0.569b | 3.530 (–2.683 to 9.744) | 0.255 |
6 | –0.586 (–2.476 to 1.303) | –2.641 (–5.453 to 0.171) | 0.523 | 0.083b | –0.772 (–2.711 to 1.167) | 0.423 | |
9 | –0.504 (–1.609 to 0.601) | 0.068 (–4.604 to 4.739) | 0.376b,* | 0.976 | 1.004 (–3.043 to 5.051) | 0.616 | |
12 | –0.683 (–2.561 to 1.195) | –0.963 (–3.480 to 1.555) | 0.098b,* | 0.605b | 0.681 (–2.311 to 3.672) | 0.645 |
Variable | Time (mo) |
Mean change (95% CI) |
p-value within controla | p-value within MCOa | Adjusted mean difference between the groups (95% CI)c | p-value between groupsd | |
---|---|---|---|---|---|---|---|
Control group | MCO group | ||||||
GDF15 | 6–baseline | –856.429 (–3,232.594 to 1,519.736) | 254.667 (–539.063 to 1,048.396) | 0.612 | 0.508 | 138.773 (–1,785.977 to 2,063.524) | 0.544 |
12–baseline | –889.286 (–3,222.725 to 1,444.153) | –118.111 (–798.284 to 562.062) | 0.387 | 0.719 | –593.600 (–2,126.963 to 939.764) | 0.119 | |
12–6 | –32.857 (–1,200.064 to 1,134.350) | –372.778 (–1,196.203 to 450.648) | 0.947 | 0.353 | –1,063.359 (–2,296.294 to 169.575) | 0.086 | |
Leptin | 6–baseline | 829.714 (–7,823.227 to 9,482.656) | –933.239 (–6,324.394 to 4,457.915) | 0.822 | 0.948b | –2,229.025 (–11,295.350 to 6,837.299) | 0.799 |
12–baseline | 1,051.286 (–8,557.041 to 10,659.612) | 966.063 (–8,405.512 to 10,337.640) | 0.798 | 0.267b | –1,144.737 (–14,473.017 to 12,183.543) | 0.841 | |
12–6 | 221.571 (–11,512.530 to 11,955.673) | 1,899.303 (–4,885.581 to 8,684.188) | 0.965 | 0.199b | 562.211 (–10,874.046 to 11,998.468) | 0.986 | |
Sclerostin | 6–baseline | 1,437.1 (795.7 to 2,078.6) | –188.9 (–662.6 to 284.6) | 0.018b,* | 0.412 | –1,616.7 (–2,477.5 to –755.9) | 0.001* |
12–baseline | 1,865.1 (875.6 to 2,854.6) | 135.3 (–637.7 to 908.3) | 0.004* | 0.715 | –1,646.9 (–3,015.2 to –278.7) | 0.033* | |
12–6 | 428.0 (–464.7 to 1,320.7) | 282.3 (–247.7 to 812.3) | 0.285 | 0.276 | –35.9 (–1,098.2 to 1,026.3) | 0.952 | |
FGF23 | 6–baseline | –73.721 (–336.639 to 189.196) | 14.018 (–189.842 to 217.879) | 0.518 | 0.723b | 66.108 (–321.391 to 453.607) | 0.637 |
12–baseline | 145.654 (–174.767. 466.075) | 71.120 (–202.381 to 344.621) | 0.309 | 0.590 | 25.928 (–474.577 to 526.433) | 0.732 | |
12–6 | 219.376 (–48.828 to 487.580) | 57.102 (–237.351 to 351.554) | 0.092 | 0.688 | 25.075 (–466.596 to 516.745) | 0.385 | |
RBP4 | 6–baseline | –583.714 (–12,401.678 to 11,234.249) | –2,303.688 (–8,207.863 to 3,600.488) | 0.908 | 0.419 | –2,229.925 (–12,792.592 to 8,332.742) | 0.648 |
12–baseline | –17,337.286 (–32,002.551 to –2,672.020) | –14,794.667 (–21,606.880 to –7,982.453) | 0.028* | 0.006b,* | 538.200 (–10,878.671 to 11,955.072) | 0.977 | |
12–6 | –16,753.571 (–27,344.178 to –6,162.965) | –12,334.400 (–21,455.745 to –3,219.055) | 0.008* | 0.012* | 597.652 (–11,102.058 to 12,297.362) | 0.950 | |
β2MG | 6–baseline | –7,101.714 (–23,190.394 to 8,986.965) | –3,628.000 (–34,071.355 to 26,815.355) | 0.322 | 0.803 | 17,504.945 (–15,241.088 to 50,250.979) | 0.187 |
12–baseline | –35,975.571 (–67,157.403 to –4,793.740) | –61,236.067 (–95,247.526 to –27,224.607) | 0.030* | 0.001b,* | 1,085.527 (–13,305.429 to 15,476.482) | 0.985 | |
12–6 | –28,873.857 (–605,21.140 to 2,773.426) | –51,036.667 (–74,449.806 to –27,623.527) | 0.067 | <0.0001* | 1,083.954 (–14,389.169 to 16,557.078) | 0.964 |
Variable |
ΔSclerostin |
|||
---|---|---|---|---|
Total | Control group | MCO group | ||
ΔP | r | 0.064 | 0.143 | –0.229 |
p | 0.767 | 0.760 | 0.376 | |
n | 34 | 18 | 16 | |
ΔTotal protein | r | –0.006 | 0.242 | –0.107 |
p | 0.978 | 0.601 | 0.682 | |
No. | 34 | 18 | 16 | |
ΔAlbumin | r | 0.109 | –0.424 | –0.039 |
p | 0.613 | 0.343 | 0.883 | |
No. | 34 | 18 | 16 | |
ΔCa | r | 0.074 | –0.758* | –0.142 |
p | 0.730 | 0.048* | 0.587 | |
No. | 34 | 18 | 16 | |
ΔCRP | r | –0.177 | –0.234 | –0.208 |
p | 0.4080 | 0.613 | 0.423 | |
No. | 34 | 18 | 16 |
Seon-Ho Ahn
https://orcid.org/0000-0002-3482-1056
Mi Mi Ko
https://orcid.org/0000-0002-5758-4655
Ju Hung Song
https://orcid.org/0000-0002-8149-2195
Jong Hwan Jung
https://orcid.org/0000-0002-1252-9679