Assessment of Proximal Tubular Function by Tubular Maximum Phosphate Reabsorption Capacity in Heart Failure Article Swipe
Johanna E. Emmens
,
Martin H. de Borst
,
Eva M. Boorsma
,
Kevin Damman
,
Gerjan Navis
,
Dirk J. van Veldhuisen
,
Kenneth Dickstein
,
Stefan D. Anker
,
Chim C. Lang
,
Gerasimos Filippatos
,
Marco Metra
,
Nilesh J. Samani
,
Piotr Ponikowski
,
Leong L. Ng
,
Adriaan A. Voors
,
Jozine M. ter Maaten
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2215/cjn.03720321
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2215/cjn.03720321
Background and objectives The estimated glomerular filtration rate (eGFR) is a crucial parameter in heart failure. Much less is known about the importance of tubular function. We addressed the effect of tubular maximum phosphate reabsorption capacity (TmP/GFR), a parameter of proximal tubular function, in patients with heart failure. Design, setting, participants, & measurements We established TmP/GFR (Bijvoet formula) in 2085 patients with heart failure and studied its association with deterioration of kidney function (>25% eGFR decrease from baseline) and plasma neutrophil gelatinase–associated lipocalin (NGAL) doubling (baseline to 9 months) using logistic regression analysis and clinical outcomes using Cox proportional hazards regression. Additionally, we evaluated the effect of sodium-glucose transport protein 2 (SGLT2) inhibition by empagliflozin on tubular maximum phosphate reabsorption capacity in 78 patients with acute heart failure using analysis of covariance. Results Low TmP/GFR (<0.80 mmol/L) was observed in 1392 (67%) and 21 (27%) patients. Patients with lower TmP/GFR had more advanced heart failure, lower eGFR, and higher levels of tubular damage markers. The main determinant of lower TmP/GFR was higher fractional excretion of urea ( P <0.001). Lower TmP/GFR was independently associated with higher risk of plasma NGAL doubling (odds ratio, 2.20; 95% confidence interval, 1.05 to 4.66; P =0.04) but not with deterioration of kidney function. Lower TmP/GFR was associated with higher risk of all-cause mortality (hazard ratio, 2.80; 95% confidence interval, 1.37 to 5.73; P =0.005), heart failure hospitalization (hazard ratio, 2.29; 95% confidence interval, 1.08 to 4.88; P =0.03), and their combination (hazard ratio, 1.89; 95% confidence interval, 1.07 to 3.36; P =0.03) after multivariable adjustment. Empagliflozin significantly increased TmP/GFR compared with placebo after 1 day ( P =0.004) but not after adjustment for eGFR change. Conclusions TmP/GFR, a measure of proximal tubular function, is frequently reduced in heart failure, especially in patients with more advanced heart failure. Lower TmP/GFR is furthermore associated with future risk of plasma NGAL doubling and worse clinical outcomes, independent of glomerular function.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2215/cjn.03720321
- https://cjasn.asnjournals.org/content/clinjasn/17/2/228.full.pdf
- OA Status
- hybrid
- Cited By
- 13
- References
- 50
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4210720621
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4210720621Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.2215/cjn.03720321Digital Object Identifier
- Title
-
Assessment of Proximal Tubular Function by Tubular Maximum Phosphate Reabsorption Capacity in Heart FailureWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-02-01Full publication date if available
- Authors
-
Johanna E. Emmens, Martin H. de Borst, Eva M. Boorsma, Kevin Damman, Gerjan Navis, Dirk J. van Veldhuisen, Kenneth Dickstein, Stefan D. Anker, Chim C. Lang, Gerasimos Filippatos, Marco Metra, Nilesh J. Samani, Piotr Ponikowski, Leong L. Ng, Adriaan A. Voors, Jozine M. ter MaatenList of authors in order
- Landing page
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https://doi.org/10.2215/cjn.03720321Publisher landing page
- PDF URL
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https://cjasn.asnjournals.org/content/clinjasn/17/2/228.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
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https://cjasn.asnjournals.org/content/clinjasn/17/2/228.full.pdfDirect OA link when available
- Concepts
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Renal function, Medicine, Heart failure, Confidence interval, Hazard ratio, Internal medicine, Empagliflozin, Cardiology, Odds ratio, Endocrinology, Urology, Creatinine, Reabsorption, Gastroenterology, Kidney, Diabetes mellitus, Type 2 diabetesTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
13Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 4, 2024: 5, 2023: 3, 2022: 1Per-year citation counts (last 5 years)
- References (count)
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50Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.=0.005), | 229 |
| abstract_inverted_index.Patients | 146 |
| abstract_inverted_index.TmP/GFR, | 282 |
| abstract_inverted_index.advanced | 152, 300 |
| abstract_inverted_index.analysis | 92, 129 |
| abstract_inverted_index.capacity | 35, 120 |
| abstract_inverted_index.clinical | 94, 317 |
| abstract_inverted_index.compared | 265 |
| abstract_inverted_index.decrease | 75 |
| abstract_inverted_index.doubling | 84, 190, 314 |
| abstract_inverted_index.failure, | 154, 294 |
| abstract_inverted_index.failure. | 15, 47, 302 |
| abstract_inverted_index.formula) | 57 |
| abstract_inverted_index.function | 72 |
| abstract_inverted_index.logistic | 90 |
| abstract_inverted_index.markers. | 163 |
| abstract_inverted_index.observed | 138 |
| abstract_inverted_index.outcomes | 95 |
| abstract_inverted_index.patients | 44, 60, 123, 297 |
| abstract_inverted_index.proximal | 40, 286 |
| abstract_inverted_index.setting, | 49 |
| abstract_inverted_index.(<0.80 | 135 |
| abstract_inverted_index.(baseline | 85 |
| abstract_inverted_index.addressed | 27 |
| abstract_inverted_index.all-cause | 217 |
| abstract_inverted_index.baseline) | 77 |
| abstract_inverted_index.estimated | 4 |
| abstract_inverted_index.evaluated | 103 |
| abstract_inverted_index.excretion | 173 |
| abstract_inverted_index.function, | 42, 288 |
| abstract_inverted_index.function. | 25, 208, 322 |
| abstract_inverted_index.increased | 263 |
| abstract_inverted_index.interval, | 196, 224, 238, 252 |
| abstract_inverted_index.lipocalin | 82 |
| abstract_inverted_index.mortality | 218 |
| abstract_inverted_index.outcomes, | 318 |
| abstract_inverted_index.parameter | 12, 38 |
| abstract_inverted_index.patients. | 145 |
| abstract_inverted_index.phosphate | 33, 118 |
| abstract_inverted_index.transport | 108 |
| abstract_inverted_index.(TmP/GFR), | 36 |
| abstract_inverted_index.Background | 0 |
| abstract_inverted_index.adjustment | 277 |
| abstract_inverted_index.associated | 183, 212, 307 |
| abstract_inverted_index.confidence | 195, 223, 237, 251 |
| abstract_inverted_index.especially | 295 |
| abstract_inverted_index.filtration | 6 |
| abstract_inverted_index.fractional | 172 |
| abstract_inverted_index.frequently | 290 |
| abstract_inverted_index.glomerular | 5, 321 |
| abstract_inverted_index.importance | 22 |
| abstract_inverted_index.inhibition | 112 |
| abstract_inverted_index.neutrophil | 80 |
| abstract_inverted_index.objectives | 2 |
| abstract_inverted_index.regression | 91 |
| abstract_inverted_index.<0.001). | 178 |
| abstract_inverted_index.Conclusions | 281 |
| abstract_inverted_index.adjustment. | 260 |
| abstract_inverted_index.association | 67 |
| abstract_inverted_index.combination | 246 |
| abstract_inverted_index.covariance. | 131 |
| abstract_inverted_index.determinant | 166 |
| abstract_inverted_index.established | 54 |
| abstract_inverted_index.furthermore | 306 |
| abstract_inverted_index.independent | 319 |
| abstract_inverted_index.regression. | 100 |
| abstract_inverted_index.measurements | 52 |
| abstract_inverted_index.proportional | 98 |
| abstract_inverted_index.reabsorption | 34, 119 |
| abstract_inverted_index.Additionally, | 101 |
| abstract_inverted_index.Empagliflozin | 261 |
| abstract_inverted_index.deterioration | 69, 205 |
| abstract_inverted_index.empagliflozin | 114 |
| abstract_inverted_index.independently | 182 |
| abstract_inverted_index.multivariable | 259 |
| abstract_inverted_index.participants, | 50 |
| abstract_inverted_index.significantly | 262 |
| abstract_inverted_index.sodium-glucose | 107 |
| abstract_inverted_index.hospitalization | 232 |
| abstract_inverted_index.gelatinase–associated | 81 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 89 |
| countries_distinct_count | 7 |
| institutions_distinct_count | 16 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8399999737739563 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.85397039 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |