Investigating the Correlation between Serum Cholinesterase Levels and Kidney Function

Background: Serum cholinesterase is a commonly used biomarker for organophosphate poisoning and liver function assessment. However, the relationship between serum cholinesterase levels and renal function, as defined by estimated Glomerular Filtration Rate (eGFR), remains poorly understood. This retrospective study aimed to explore the correlation between these two biomarkers in a large patient cohort. Methods: We retrospectively analyzed data from 488,118 patients aged 18 years or older with renal and liver function data from Guangdong Provincial People's Hospital from January 2019 to October 2023. Patients with abnormal liver function tests were excluded. Patients were stratified into five groups based on estimated glomerular filtration rate (eGFR) according to KDIGO CKD staging guidelines. Serum cholinesterase levels were compared across these groups using the Kruskal-Wallis test. Statistical analyses were performed using SPSS version 22.0. Results: The median serum cholinesterase in the study population was 7837.00 U/L (IQR: 6693.00 - 9018.00 U/L). A significant inverse correlation was observed between serum cholinesterase levels and eGFR (p < 0.01). Median serum cholinesterase levels decreased progressively with declining eGFR, as shown below: eGFR ≥ 90 mL/min/1.73 m2 : 7917.0 (6789.0, 9097.0) U/L eGFR 60-89 mL/min/1.73 m2: 7888.0(6768.0,9035.0)U/L eGFR 30-59 mL/min/1.73 m2:7251.0(6097.0,8451.0)U/L eGFR 15-29 mL/min/1.73 m2: 6201.0(4982.5,7468.5)U/L eGFR < 15 mL/min/1.73 m2: 5907.0(4861.0,6980.0) U/L Pairwise comparisons between each eGFR group also revealed statistically significant differences (p < 0.01). Conclusion: Our findings demonstrate a clear association between serum cholinesterase levels and renal function decline. As eGFR decreases, serum cholinesterase levels significantly decrease, suggesting a potential role for serum cholinesterase as a marker of renal dysfunction progression. Further research is warranted to explore the clinical implications of this association.