Good-Cholesterol Levels Determine Mortality Risk in CKD Patients
Low high-density lipoprotein cholesterol (HDL-C) levels lead to a higher risk for cardiovascular and all-cause mortality in patients with chronic kidney disease (CKD), according to a recent study. However, high HDL-c levels lead to a higher risk of non-cardiovascular/non-malignancy related deaths in men only.
Findings were presented at the American Society of Nephrology’s Kidney Week 2017, which is taking place from October 31 to November 5, 2017, in New Orleans, Louisiana.
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For their study, the researchers evaluated 38,377 patients with CKD. All patients included in the study had an estimated glomerular filtration rate (eGFR) of 15 to 59 ml/min/1.73 m2 and had available lipid level measurements that had been taken within 1 year of CKD diagnosis. Follow-up lasted a median 4.5 years.
State mortality data was used to determine overall and cause-specific mortality. Deaths were classified into categories of cardiovascular, malignancy, or non-cardiovascular/non-malignancy causes. Associations between causes of death and HDL-C were assessed by categories of HDL-C: 30 mg/dl or less, 31 to 40 mg/dl, 41-50 mg/dl (reference), 51 to 60 mg/dl, and more than 60 mg/dl. Separate analyses were performed for men and women.
A total of 9665 patients had died over the course of follow-up. Results indicated that an HDL-C level of 30 mg/dl or less was associated with a higher risk for all-cause mortality and cardiovascular mortality in both men and women, and with a higher risk for malignancy-related deaths in women.
An HDL-C level of more than 60 mg/dl was associated with a lower risk for all-cause mortality in women only, and with a higher risk for non-cardiovascular/non-malignancy-related deaths in men only.
“Additional studies examining the reasons for these different associations between HDL-C and cause-specific mortality, and potential effect modification by sex, are needed,” the researchers concluded.
—Christina Vogt
Reference:
Navaneethan SD, Schold JD, Arrigain S, et al. HDL cholesterol and its associations with cause-specific mortality in patients with CKD. Paper presented at: American Society of Nephrology Kidney Week 2017; October 31-November 5, 2017; New Orleans, LA. https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2759702.