Lipid disorders in patients with renal failure: Role in cardiovascular events and progression of chronic kidney disease

Visconti, Luca; Benvenga, Salvatore; Lacquaniti, Antonio; Cernaro, Valeria; Bruzzese, Annamaria; Conti, Giovanni; Buemi, Michele; Santoro, Domenico

doi:10.1016/j.jcte.2016.08.002

Cited by 42 publications

(44 citation statements)

References 74 publications

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“…In CKD populations, the relationship between TG level and risk of death remains uncertain, as does the relationship between TG and risk of progression to ESRD (45,46). In the present study, the TG level at baseline and its longitudinal change pattern were not associated with a rapid Supplemental Material can be found at: Fig.…”

Section: Discussionmentioning

confidence: 54%

Longitudinal lipid trends and adverse outcomes in patients with CKD: a 13-year observational cohort study

Tsai

Huang

Chiang

et al. 2019

Journal of Lipid Research

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Studies on the effects of longitudinal lipid trajectories on end-stage renal disease (ESRD) development and deaths among patients with chronic kidney disease (CKD) are limited. We conducted a registry-based prospective study using data from a 13-year multidisciplinary pre-ESRD care program. The final study population comprised 4,647 patients with CKD. Using group-based trajectory modeling, we dichotomized longitudinal trajectories of total cholesterol (T-CHO), triglyceride (TG), LDL cholesterol (LDL-C), and HDL cholesterol (HDL-C). Time to ESRD or death was analyzed using multiple Cox regression. At baseline, higher levels of T-CHO and LDL-C were associated with rapid progression to ESRD, whereas only HDL-C was positively associated with all-cause mortality [adjusted hazard ratio (HR), 1.20; 95% CI, 1.06-1.36; P-value, 0.005]. Compared with those with a normal T-CHO trajectory, the fully adjusted HR of patients with a high T-CHO trajectory for ESRD risk was 1.21 (P-value, 0.019). Subgroup analysis showed that a high TG trajectory was associated with a 49% increase in mortality risk in CKD patients without diabetes (P-value for interaction, 0.012). In contrast to what was observed based on baseline HDL-C, patients with a trajectory of frequent hypo-HDL cholesterolemia had higher risk of all-cause mortality (adjusted HR, 1.53; P-value, 0.014). Thus, only T-CHO, both at baseline and over the longitudinal course, demonstrated a significant potential risk of incident ESRD. The inconsistency in the observed directions of association between baseline levels and longitudinal trajectories of HDL-C warrants further research to unveil specific pathogenic mechanisms underlying the HDL-C metabolism in patients with CKD.-

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Section: Discussionmentioning

confidence: 54%

Longitudinal lipid trends and adverse outcomes in patients with CKD: a 13-year observational cohort study

Tsai

Huang

Chiang

et al. 2019

Journal of Lipid Research

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“…In general, renal dysfunction changes the level, composition, and quality of these lipids in favour of a more atherogenic profile [18][19][20][21] . The characteristic lipid pattern in patients with CKD stage 3 or higher consists of hypertriglyceridemia [G] , low levels of high-density lipoprotein (HDL) cholesterol and variable levels of low-density lipoprotein (LDL) cholesterol and total cholesterol 18,19,[22][23][24][25] . However, different CKD stages, modes of dialysis and levels of proteinuria are associated with specific lipid profiles (Table 1).…”

Section: Headings We Have a Limit For [H2] Subheadings Of 39 Charactmentioning

confidence: 99%

Lipid management in patients with chronic kidney disease

Ferro¹,

Mark²,

Kanbay³

et al. 2018

Nat Rev Nephrol

171

142

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Glomerular filtration rate is inversely associated with cardiovascular disease independent of conventional risk factors. An increased risk of cardiovascular disease is present even at minor levels of renal impairment and the risk is highest in patients with endstage renal disease (ESRD) requiring dialysis. Renal dysfunction changes the level, composition, and quality of blood lipids in favour of a more atherogenic profile. Patients with advanced chronic kidney disease or ESRD have a characteristic lipid pattern of hypertriglyceridemia and low HDL-cholesterol levels but normal LDL-cholesterol levels. In the general population, a clear relationship exists between LDL-cholesterol, coronary heart disease and ischaemic stroke. However, in patients with ESRD, LDL-cholesterol seems to show a negative association [Au: with these outcomes?] at below average LDL-cholesterol levels and a flat or weakly positive association with mortality at higher LDL-cholesterol levels. Overall, the available data suggest that lowering of LDL-cholesterol is beneficial for prevention of major atherosclerotic events in patients with chronic kidney disease and in kidney transplant recipient but is not beneficial in patients requiring dialysis. [Au: I've moved the description of the content of your Review to the end of the introduction as per our journal style. To fully reflect the content of your article, please finish off the abstrace with a couple of sentences relating to novel lipid-lowering therapies and the need for reconsideration of the KDIGO guidelines in the light of new data. We have a limit of 200 words for this section.] [Au: I have highlighted suggestions for glossary terms throughout your manuscript with a [G]. Please provide succinct, one-sentence definitions for these specialist terms.] [H1] Introduction Guidelines regarding the management of lipids in patients with chronic kidney disease (CKD) and especially in those with end-stage renal disease (ESRD) are inconsistent in part owing to important deficiencies in the available data. [Au: Edit OK?] In 2013 KDIGO produced a comprehensive clinical practice guideline for lipid management in CKD 1. [Au: I suggest that we cite your original Table 1 (now Table 3) in the discussion of KDIGO recommendations at the end of the review so that the table is included next to this discussion in the final layout rather than in the introduction to the Review.

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“…One recent randomization analysis demonstrated that genetically higher HDL cholesterol concentration was associated with better kidney function based on large samples form the largest lipid and CKD cohorts [11]. Visconti L et al [38] also reported lipid disorders in CKD was characterized by reduced HDL-C, high triglycerides and normal or slightly reduced LDL-C level. The mechanism for the association is not entirely clear, previous studies showed that the HDL-C had the antioxidant, anti-inflammatory and antithrombotic functions, which would reduce atherosclerosis in renal arteries and other arteries, it may serve as the protector of the renal functions [39].…”

Section: Discussionmentioning

confidence: 99%

Association Between the Lipid Profile and Renal Dysfunction in the Heart Failure Patients

Zhang

Shi

Zhao

et al. 2019

Kidney Blood Press Res

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Background/Aims: In heart failure patients with high prevalence of chronic renal disease (CKD), hospitalization and mortality, whether the lipid profile was associated with renal dysfunction remained unknown. The present study intended to clarify the association between the lipid profile and renal dysfunction in the heart failure patients. Methods: 336 hospitalized heart failure patients with left ventricle ejection fraction (LVEF) ≤45% and New York Heart Association (NYHA) class II-IV were enrolled. The estimated glomerular filtration rate (eGFR) < 90 mL/min·1.73 m² was defined as renal dysfunction. The demographic, clinical data, blood samples and echocardiography were documented. The Pearson simple linear correlation was performed to evaluate the confounding factors correlated with eGFR. The significantly correlated factors were enrolled in Logistic regression as confounding factors to determine the association between the lipid profile and renal dysfunction in the heart failure patients. Results: 182 patients (54.2%) had renal dysfunction and 154 patients (45.8%) did not have renal dysfunction. The waist circumference, platelet counts, platelet distribution width (PDW), high density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 (apoA1), albumin and left ventricular ejection fraction (LVEF) are positively correlated with eGFR (all P< 0.05). Meanwhile, the age, mean platelet volume (MPV), neutrophilic granulocyte percentage (NEUT%), urea nitrogen (BUN), creatinine and total bilirubin (TBIL) are negatively correlated with eGFR (all P< 0.05). The total cholesterol (TC), triglyceride, low density lipoprotein-cholesterol (LDL-C) and apolipoprotein B (apoB) show no correlation with eGFR. After the adjustment of sex, hypertension, diabetes mellitus, age, waist circumference, platelet counts, MPV, PDW, NEUT%, TBIL, albumin and LVEF, HDL-C is the only lipid factor still significantly associated with renal dysfunction in hospitalized heart failure patients (OR=0.119, P=0.003). Conclusion: Among the lipid profile of TC, triglyceride, LDL-C, HDL-C, apo A1 and apo B, the HDL-C is the only lipid factor significantly associated with renal dysfunction in hospitalized heart failure patients.

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Lipid disorders in patients with renal failure: Role in cardiovascular events and progression of chronic kidney disease

Cited by 42 publications

References 74 publications

Longitudinal lipid trends and adverse outcomes in patients with CKD: a 13-year observational cohort study

Longitudinal lipid trends and adverse outcomes in patients with CKD: a 13-year observational cohort study

Lipid management in patients with chronic kidney disease

Association Between the Lipid Profile and Renal Dysfunction in the Heart Failure Patients

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