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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
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