Abstract
Objective Few studies have investigated the association of apolipoprotein B (ApoB) with the progression of diabetic kidney disease (DKD) and the risk of renal replacement therapy (RRT). Method In this retrospective cohort study, a group of 258 DKD patients with stage 3–5chronic kidney disease(CKD)were divided into low ApoB (<1.1 g/L) and high ApoB (≥1.1 g/L) groups and followed-up for 20.51 ± 6.11 months. The association of the serum ApoB concentration with RRT was determined by Kaplan–Meier and Cox regression analysis. ApoB was measured in the serum. Results Ninety-three of the 258 DKD patients needed RRT during follow-up. Kaplan–Meier analysis showed that patients with high ApoB were significantly more likely to progress to RRT than those with low ApoB (log-rank = 16.62, p < 0.001). The presence of high ApoB increased the risk of RRT. Analysis of ApoB as either a categorical (<1.1 g/L or ≥1.1 g/l) or continuous variable by univariate and multivariate regression found that ApoB was an independent risk factor of DKD progression to RRT in this group of DKD patients with stage 3–5 CKD (p < 0.05). Conclusion Increased ApoB was an independent predictor of progression to RRT. A larger study is needed to confirm the unfavorable prognosis of increased ApoB in DKD patients.
Highlights
Chronic kidney disease (CKD) leads to loss of renal function
apolipoprotein B (ApoB) is increased at all stages of CKD, and as catabolism of very low-density lipid (VLDL)-ApoB-100 is slowed in CKD, accumulation of ApoB-containing lipoproteins may result primarily from decreased clearance rather than from increased synthesis [8–10]
Kaplan–Meier analysis and multifactor Cox regression found that ApoB, as both a categorical (
Summary
Chronic kidney disease (CKD) leads to loss of renal function. It is a public health problem worldwide, and the estimated prevalence in adults in the Chinese population is 10.8% [1,2]. Serum lipid abnormalities may be independent risk factors for CKD progression. Apolipoprotein (Apo) B present in the serum is composed of two subunits, ApoB 100 and ApoB 48 It transports plasma lipids and is required for the formation of various plasma lipoprotein particles. But not all, studies have found that ApoB and low-density lipid cholesterol (LDL-C) were independently associated with CKD progression [13–16]. The Chronic Renal Insufficiency Cohort Study (CRIC) study found that blood lipids were not independently associated with CKD progression. A retrospective study of over 10,000 healthy participants did not find a longitudinal association between incident CKD and baseline ApoB or ApoB/
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