Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov;56(11):3665-3677.
doi: 10.1007/s11255-024-04119-0. Epub 2024 Jun 19.

Association between serum chloride levels and estimated glomerular filtration rate among US adults: evidence from NHANES 1999-2018

Peipei Zhao #  1   2 , Yiping Li #  3 , Zhewei Fei  4 , Leyi Gu  1 , Baosan Han  5 , Ping Ye  6 , Huili Dai  7   8
Affiliations

Association between serum chloride levels and estimated glomerular filtration rate among US adults: evidence from NHANES 1999-2018

Peipei Zhao et al. Int Urol Nephrol. 2024 Nov.

Abstract

Purpose: Chloride, the predominant anion in extracellular fluid from humans, is essential to maintaining homeostasis. One important metric for thoroughly assessing kidney function is the estimated glomerular filtration rate (eGFR). However, the relationship between variations in serum chloride concentration and eGFR in general populations has been poorly studied. Therefore, the purpose of this study is to elucidate the correlation between serum chloride levels and eGFR within the United States' adult population.

Methods: This cohort study was conducted using data from the National Health and Nutrition Examination Survey (NHANES), which covered the years 1999-2018. We employed multiple linear regression analysis and subgroup analysis to evaluate the correlation between serum chloride concentration and eGFR. To examine the nonlinear association between serum chloride levels and eGFR, restricted cubic spline analyses were employed.

Results: Data from 49,008 participants in this cohort study were used for the chloride analysis. In the comprehensively adjusted model, a noteworthy inverse relationship was discovered between chloride plasma concentration and eGFR. Restricted cubic spline analyses revealed a significant nonlinear relationship between chloride levels and eGFR (P for overall < 0.001 and P for nonlinear < 0.001). A significant interaction was observed between eGFR and plasma chloride concentration (all P < 0.001 for interaction) among the subgroups characterized by sex, household income to poverty ratio, BMI, hypertension, and diabetes.

Conclusion: Our findings suggest that higher levels of chloride plasma concentration were linked to decreased eGFR. These findings underscore the significance of monitoring chloride plasma concentration as a potential indicator for identifying individuals at risk of developing chronic kidney disease (CKD).

Keywords: Chronic kidney disease; Epidemiology; Estimated glomerular filtration rate (eGFR); National Health and Nutrition Examination Survey (NHANES); Serum chloride.

PubMed Disclaimer

Conflict of interest statement

All the authors certify that they have no conflicting financial interests.

Figures

Fig. 1
Fig. 1
Flowchart of the screening process for selecting eligible participants. NHANES the National Health and Nutrition Examination Survey, eGFR estimated glomerular filtration rate
Fig. 2
Fig. 2
Restricted cubic spline (RCS) analysis with multivariate-adjusted associations between serum chloride levels and eGFR in adults. Models adjusted for age, gender, race, marital status, education level, family income to poverty ratio, body mass index, smoking status, alcohol intake, hypertension, diabetes, congestive heart failure, stroke, total cholesterol and serum bicarbonate. eGFR estimated glomerular filtration rate
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Chronic Kidney Disease Prognosis C, Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS et al (2010) Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet 375(9731):2073–2081. 10.1016/S0140-6736(10)60674-5 - PMC - PubMed
    1. Levin A, Ahmed SB, Carrero JJ, Foster B, Francis A, Hall RK et al (2024) Executive summary of the KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease: known knowns and known unknowns. Kidney Int 105(4):684–701. 10.1016/j.kint.2023.10.016 - PubMed
    1. Matsushita K, Ballew SH, Wang AY, Kalyesubula R, Schaeffner E, Agarwal R (2022) Epidemiology and risk of cardiovascular disease in populations with chronic kidney disease. Nat Rev Nephrol 18(11):696–707. 10.1038/s41581-022-00616-6 - PubMed
    1. Writing Group for the CKDPC, Grams ME, Coresh J, Matsushita K, Ballew SH, Sang Y et al (2023) Estimated glomerular filtration rate, albuminuria, and adverse outcomes: an individual-participant data meta-analysis. JAMA 330(13):1266–1277. 10.1001/jama.2023.17002 - PMC - PubMed
    1. Collaboration GBDCKD (2020) Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet 395(10225):709–733. 10.1016/S0140-6736(20)30045-3 - PMC - PubMed

LinkOut - more resources