Low levels of high-density lipoprotein cholesterol increase the risk of incident kidney disease and its progression
Autor: | Sumitra Balasubramanian, Hong Xian, Ziyad Al-Aly, Benjamin Bowe, Yan Xie |
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Rok vydání: | 2016 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Urology Renal function 030204 cardiovascular system & hematology urologic and male genital diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Internal medicine medicine Humans Renal Insufficiency Chronic Survival analysis Dialysis Aged Retrospective Studies Creatinine business.industry Cholesterol HDL Hazard ratio Middle Aged medicine.disease United States Transplantation Endocrinology chemistry Nephrology Disease Progression lipids (amino acids peptides and proteins) business Body mass index Glomerular Filtration Rate Kidney disease |
Zdroj: | Kidney International. 89:886-896 |
ISSN: | 0085-2538 |
Popis: | Available experimental evidence suggests a role for high-density lipoprotein cholesterol (HDL-C) in incident chronic kidney disease (CKD) and its progression. However, clinical studies are inconsistent. We therefore built a cohort of 1,943,682 male US veterans and used survival models to examine the association between HDL-C and risks of incident CKD or CKD progression (doubling of serum creatinine, eGFR decline of 30% or more), or a composite outcome of ESRD, dialysis, or renal transplantation. Models were adjusted for demographics, comorbid conditions, eGFR, body mass index, lipid parameters, and statin use over a median follow-up of 9 years. Compared to those with HDL-C of 40 mg/dl or more, low HDL-C (under 30 mg/dl) was associated with increased risk of incident eGFR under 60 ml/min/1.73 m(2) (hazard ratio: 1.18; confidence interval: 1.17-1.19) and risk of incident CKD (1.20; 1.18-1.22). Adjusted models demonstrate an association between low HDL-C and doubling of serum creatinine (1.14; 1.12-1.15), eGFR decline of 30% or more (1.13; 1.12-1.14), and the composite renal end point (1.08; 1.06-1.11). Cubic spline analyses of the relationship between HDL-C levels and renal outcomes showed a U-shaped relationship, where risk was increased in lowest and highest deciles of HDL-C. Thus, a significant association exists between low HDL-C levels and risks of incident CKD and CKD progression. Further studies are needed to explain the increased risk of adverse renal outcomes in patients with high HDL-C. |
Databáze: | OpenAIRE |
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