Abstract
Dyslipidemia is common in patients with chronic kidney disease (CKD), however the relationship between dyslipidemia and mortality in patients with moderate to severe CKD remains controversial. Non-high-density lipoprotein (HDL) cholesterol has been reported to be a more accurate predictor of clinical outcomes than conventional lipid measurements. Hence, the aim of this study was to investigate associations between non-HDL cholesterol and the risk of overall and cardiovascular mortality in patients with CKD stage 3–5. We enrolled 429 pre-dialysis patients with stage 3 to 5 CKD from May 2006 to January 2010. The patients were divided into four groups according to quartiles of non-HDL cholesterol. The patients were followed until death or until January 2020. During a median 11.6 years of follow-up, there were 78 (18.2%) deaths overall and 32 (7.5%) cardiovascular deaths. In adjusted models, the patients in quartile 1 (hazard ratio [HR] 3.368; 95% confidence interval [CI] 1.388–8.176; p = 0.007), quartile 3 (HR 3.666; 95% CI 1.486–9.044; p = 0.005), and quartile 4 (HR 2.868; 95% CI 1.136–7.240; p = 0.026) of non-HDL cholesterol had a higher risk of overall mortality (vs. quartile 2). In addition, the patients in quartile 1 (HR 19.503; 95% CI 2.185–174.0925 p = 0.008), quartile 3 (HR 28.702; 95% CI 2.990–275.559; p = 0.004), and quartile 4 (HR 11.136; 95% CI 1.126–110.108; p = 0.039) had a higher risk of cardiovascular mortality (vs. quartile 2). Our study showed a U-shaped relationship between non-HDL cholesterol and the risk of overall and cardiovascular mortality in patients with CKD stage 3–5. Assessing non-HDL cholesterol may help to identify subjects at high-risk of adverse outcomes.
Highlights
Dyslipidemia is common in patients with chronic kidney disease (CKD), the relationship between dyslipidemia and mortality in patients with moderate to severe CKD remains controversial
Dyslipidemia is common in patients with chronic kidney disease (CKD) due to severe dysregulation of key metabolic pathways and enzymes, which can lead to a decrease in high-density lipoprotein (HDL) cholesterol and increase in triglyceride-rich lipoproteins[3]
We evaluated the association between non-HDL cholesterol and mortality in patients with CKD stages 3–5
Summary
Dyslipidemia is common in patients with chronic kidney disease (CKD), the relationship between dyslipidemia and mortality in patients with moderate to severe CKD remains controversial. The aim of this study was to investigate associations between non-HDL cholesterol and the risk of overall and cardiovascular mortality in patients with CKD stage 3–5. Our study showed a U-shaped relationship between non-HDL cholesterol and the risk of overall and cardiovascular mortality in patients with CKD stage 3–5. Dyslipidemia is common in patients with chronic kidney disease (CKD) due to severe dysregulation of key metabolic pathways and enzymes, which can lead to a decrease in high-density lipoprotein (HDL) cholesterol and increase in triglyceride-rich lipoproteins[3]. Some epidemiological studies have reported an association between non-HDL cholesterol and adverse CVD outcomes in patients with C KD18–20, whereas others have not identified such an a ssociation[21,22]. The aim of the present study was to investigate the association between non-HDL cholesterol and overall and cardiovascular mortality in patients with CKD stage 3–5
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