Elevated TG/HDL-C and Non-HDL-C/HDL-C Ratios Predict Mortality in Peritoneal Dialysis Patients

Abstract

Background and Aims: Dyslipidemia is common in patients with chronic kidney disease and particular prevalent in patients receiving peritoneal dialysis. However, whether markers of atherogenic dyslipidemia correlate with outcomes in dialysis patients as in the general population is uncertain. Here, we investigated the prognostic value of the serum triglyceride/HDL cholesterol (TG/HDL-C) ratio and non-HDL-C/HDL-C ratio in peritoneal dialysis patients to predict all-cause mortality. Methods 214 PD patients were retrospectively analyzed from January 2011 to December 2015, with a median follow-up of 59 months. We used receiver operating curves (ROC) to determine the optimal threshold for TG/HDL-C and non-HDL/HDL-C ratios at baseline to predict OS during follow-up. Prognostic values were accessed by univariate and multivariate COX regression analysis and Kaplan-Meier curve. A predictive nomogram was developed to predict prognosis for overall survival, and the predictive accuracy was evaluated by concordance index (c-index). Results The optimal cut-off values for TG/HDL-C ratio and non-HDL-C/HDL-C ratio were 1.94 and 2.86, respectively. A high TG/HDL-C ratio and a high non-HDL-C/HDL-C ratio strongly correlated with worse OS in PD patients. Multivariate analysis demonstrated that elevated TG/HDL-C ratio as well as non-HDL/HDL-C ratios were independent markers to predict reduced OS. The TG/HDL-C ratio (HR 2.60, 95% CI 1.40–4.83, P = 0.002) was superior to non-HDL-C/HDL-C ratio based on hazard ratio (HR 2.43, 95% CI 1.09–5.40, P = 0.029). Conclusion TG/HDL-C ratio and non-HDL-C/HDL-C were identified as potential prognostic biomarkers in PD patients. The proposed nomograms can be utilized for prediction of OS in PD patients.

Predictive Value of Objective Nutritional Indexes in Technique Failure in Peritoneal Dialysis Patients

“…In a retrospective study of 214 PD patients, triglyceride was a risk factor and HDL-C was a protective factor for mortality. 28 More recently, Wan et al 29 screened 291 PD patients to explore the association between baseline triglyceride and prognosis. They found that higher triglyceride level was an independent predictor of TF, mortality, and early-onset peritonitis.…”

Could triglyceride to high density lipoprotein-cholesterol ratio predict hepatosteatosis

“…Recent studies in literature focused on the usefulness of TG/HDL-c ratio in various clinical conditions. Authors suggested the TG/HDL-c ratio as a novel prognostic marker in patients receiving peritoneal dialysis treatment since elevated THR was correlated with worse survival in this population [9]. Chronic renal insufficiency, like liver steatosis, is a condition characterized with increased inflammatory burden.…”

Utility of TG/HDL‐c ratio as a predictor of mortality and cardiovascular disease in patients with chronic kidney disease undergoing hemodialysis: A systematic review

“…The TG/HDL-c index is an atherosclerotic marker, and higher mortality and cardiovascular events have been associated with different chronic diseases. [10][11][12][13][14][15] In patients with CKD, studies have been published in Chinese patients on peritoneal dialysis, 22,[25][26][27] kidney transplantation, 28 and there is a study in Italy in patients with diabetic kidney disease. 29 All show an association between higher TG/HDL-c with increased cardiovascular events and mortality, except in the case of patients with diabetic kidney disease, where this association was influenced by the presence of renal dysfunction.…”