Chronic kidney disease prevention campaign: relationship between proteinuria and elderly people

Association between triglyceride-glucose index and clinical outcomes among patients with chronic kidney disease: a meta-analysis

PURPOSE

To identify the relationship of triglyceride-glucose (TyG) index with clinical outcomes in chronic kidney disease (CKD) patients based on current available evidence.

METHODS

PubMed, EMBASE, Web of Science and CNKI databases were searched up to August 31, 2024. Primary outcome was the all-cause mortality. Secondary outcomes included the coronary artery disease (CAD) mortality, CKD progression, risk of severe coronary artery stenosis (SCAS), major adverse cardiovascular event (MACE), coronary artery calcification (CAC) progression, end-stage renal disease (ESRD), and nonalcoholic fatty liver disease (NAFLD). The hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were combined to assess the predictive role of TyG index for above clinical outcomes among CKD patients. All statistical analysis was performed by STATA 15.0 version.

RESULTS

Twelve studies with 26,530 cases were included. Pooled results indicated that elevated TyG index was significantly related to increased risk for all-cause mortality (HR = 1.22, 95% CI: 1.13-1.31, P<0.001). Besides, high TyG index was also associated with the CAD mortality (HR = 1.19, 95% CI: 1.04-1.36, P = 0.011), occurrence of CKD progression (HR = 1.52, 95% CI: 1.36-1.70, P<0.001), SCAS (OR = 1.79, 95% CI: 1.13-2.83, P = 0.013), MACE (OR = 1.68, 95% CI: 1.11-2.54, P = 0.014), CAC progression (OR = 1.55, 95% CI: 1.06-1.76, P = 0.02), CAD (OR = 2.865, 95% CI: 1.681-4.885, P<0.001), ESRD (OR = 1.49, 95% CI: 1.12-1.99, P = 0.006) and NAFLD (OR = 4.903, 95% CI: 3.046-7.893, P<0.001).

CONCLUSION

High TyG index predicts poor clinical outcomes and might serve as a novel prognostic indicator among CKD patients. However, more studies are still needed to verify above findings.

Dietary Magnesium Intake and Proteinuria: Is There a Relationship?

The possible relationship between dietary magnesium status and proteinuria has been suggested by a number of previous studies. However, human studies on this association are limited. Therefore, the present study aimed to investigate the independent relationship between dietary magnesium intake and urinary protein excretion. The present study was a post hoc analysis of the previous randomized clinical trial that evaluated the effect of dietary phosphorus restriction on proteinuria. The baseline data of 90 participants with proteinuria and chronic kidney disease was used to measure the association between dietary magnesium intake and proteinuria. Participants were asked to record their 24-h food intake for three days a week in a questionnaire. Urinary protein to creatinine ratio (UPCR) in a random urine sample was measured to be a marker for proteinuria. Out of 90 patients included in the study, 47 were men and 43 were women. The mean ± standard deviation of age and body mass index were 59.05 ± 14.16 years and 29.02 ± 5.54 kg/m2, respectively. The patients' average daily dietary intake of energy and magnesium were 2183 kcal and 169.44 mg, respectively. A significant inverse correlation was found between the dietary intake of magnesium and UPCR (r =  - 0.219, p = 0.042). This association remained significant even after adjusting for confounding variables (β =  - 0.222, p = 0.028). The findings of the present study showed a significant inverse relationship between the magnesium intake and proteinuria. Although, the design of the current research was cross-sectional, it has provided a basis for conducting future longitudinal studies and trials to better elucidate such a relationship.