Friday, April 1, 2011

IN THE NEWS-- Serum Bilirubin and chronic dialysis patients


Here is more data on how perhaps having Gilbert's syndrome might be protective in any medical conditions.
Gilbert sydnrome is a genetic condition that leads to a polymorphism in the activity of the hepatic bilirubin uridine diphosphate-glucuronosyltransferase (UGT1A1).  This leads to a slightly elevated indirect bilirubin and otherwise asymptomatic individuals.  Many have thought that there might be advantages to having this polymorphism as bilirubin is a natural anti oxidant.  Data from other medical diseases have suggested that it might be protective in cardiac, respiratory diseases.  Data on renal diseases have been scant except for few recent studies.
A recent study in CJASN 2011, shows a graded reverse association between serum bilirubin and adverse outcomes among chronic hemodialysis patients.  the UGT1A1 *28 polymorphism homozygous had significant higher bilirubin levels and hence had one fourth the risk for all cause mortality.

This is fascinating and more studies of these associations should be done. Close to 30% of world population has Gilbert's syndrome and perhaps it is protective in nature!!
Look at a prior post we had:
http://www.nephronpower.com/2010/10/in-news-bilirubin-might-be-protective.html
Ref:
http://www.ncbi.nlm.nih.gov/pubmed/21411679
http://www.ncbi.nlm.nih.gov/pubmed/17895455
http://www.ncbi.nlm.nih.gov/pubmed/20686447
http://www.fedprac.com/asp/archive/article.asp?ArticleID=2209&DeptID=

1 comment:

  1. you are right. This topic is interesting.The only drawback with research on this topicis that we wont be able to modify the bilirubin level. People with a high normal bilirubin may just be born lucky!!

    http://medicineforresidents.blogspot.com/2010/10/is-hyperbilirubinemia-protective.html

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