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논문분류	춘계학술대회 초록집
제목	24-hour Urinary Mineral Excretion and Its Developmental Trajectory and Longitudinal Changes in Relation to Renal Deterioration in Patients with CKD
저자	Xinru Guo
출판정보	2024; 2024(1):
키워드
초록	Objectives: The aim of this study was to investigate the trajectories and longitudinal changes of 24-hour urine mineral excretion (24-hour UME) and their association with chronic kidney disease (CKD) progression in patients with CKD stages 1-4. Methods: The study collected clinical data from patients admitted to the PLA General Hospital between January 2014 and July 2022, who had at least two 24-hour UME measurements over a year-long interval. Latent class linear mixed models (LCLMM) were used to model and visualize the 24-hour UME trajectories over three years. Multinomial regression and joint models were employed to assess the associations of 24-hour UME trajectories and longitudinal changes with rapid kidney function decline and CKD progression, respectively. Results: The study included 1,212 participants with a mean follow-up of 30 (IQR, 19-48) months. Of these, 317 (26.2%) exhibited CKD progression. The optimal linear trajectories of 7,896 UME values for each mineral were categorized into different groups. Specifically, 3 groups were identified for sodium, chloride, potassium and magnesium; 5 for calcium; and 4 for phosphorus. Multinomial logistic regression demonstrated that patients with steady lower levels of urinary calcium (OR: 10.000, 95% CI: 4.739-21.277, P<0.001) or a decreasing trajectory (OR: 9.901, 95% CI: 3.788-25.641, P<0.001) had a significantly higher risk of rapid kidney function decline than the reference group. In joint models, baseline and longitudinal 24-hour urinary potassium and calcium independently predicted CKD progression. Conclusions: This study discovered unique patterns of 24-hour urine mineral excretion in non-dialysis-dependent CKD patients. Baseline and longitudinal 24-hour urine excretion of potassium and calcium were determined to be significant factors in CKD progression, while sodium did not show a significant association.
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