Plasma lipids and risk of developing renal dysfunction: The Atherosclerosis Risk in Communities Study

Muntner, Paul; Coresh, Josef; Owen‐Smith, Jason; Eckfeldt, John H.; Klag, Michael J.

doi:10.1046/j.1523-1755.2000.00165.x

Cited by 597 publications

(461 citation statements)

References 44 publications

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“…Our results and the REGARDS study are consistent with the considerable body of literature reporting no association between total blood cholesterol and chronic kidney disease risk, with the possible exception of triglycerides and high‐density lipoprotein cholesterol 22, 23, 24. Unlike our study, the risk of end‐stage renal disease was not significantly associated with body mass index or smoking.…”

Section: Discussionsupporting

confidence: 90%

Relationship of the American Heart Association's Impact Goals (Life's Simple 7) With Risk of Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Cohort Study

Rebholz

Anderson

Grams

et al. 2016

JAHA

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BackgroundAs part of its 2020 Impact Goals, the American Heart Association developed the Life's Simple 7 metric for cardiovascular health promotion. The relationship between the Life's Simple 7 metric and incident chronic kidney disease (CKD) is unknown.Methods and ResultsWe estimated the association between Life's Simple 7 and incident CKD in 14 832 Atherosclerosis Risk in Communities study participants. Ideal levels of Life's Simple 7 health factors were the following: nonsmoker or quit >1 year ago; body mass index <25 kg/m2; ≥150 minutes/week of physical activity; healthy dietary pattern (high in fruits and vegetables, fish, and fiber‐rich whole grains; low in sodium and sugar‐sweetened beverages); total cholesterol <200 mg/dL; blood pressure <120/80 mm Hg; and fasting blood glucose <100 mg/dL. At baseline, mean age was 54 years, 55% were women, and 26% were African American. There were 2743 incident CKD cases over a median follow‐up of 22 years. Smoking, body mass index, physical activity, blood pressure, and blood glucose were associated with CKD risk (all P<0.01), but diet and blood cholesterol were not. CKD risk was inversely related to the number of ideal health factors (P‐trend<0.001). A model containing the Life's Simple 7 health factors was more predictive of CKD risk than the base model including only age, sex, race, and estimated glomerular filtration rate (Life's Simple 7 health factors area under the ROC curve: 0.73, 95% CI: 0.72, 0.74 versus base model area under the ROC curve: 0.68, 95% CI: 0.67, 0.69; P<0.001).ConclusionsThe AHA's Life's Simple 7 metric, developed to measure and promote cardiovascular health, predicts a lower risk of CKD.

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Section: Discussionsupporting

confidence: 90%

Relationship of the American Heart Association's Impact Goals (Life's Simple 7) With Risk of Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Cohort Study

Rebholz

Anderson

Grams

et al. 2016

JAHA

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“…In studies of patients with CKD (12) and without CKD (8), LDL-C and ApoB were significantly associated with a more rapid decline in renal function. Our study found no statistically significant association between LDL-C or apoB and CKD progression in the overall CRIC population, consistent with the Modification of Diet in Renal Disease and Atherosclerosis Research in Communities (ARIC) studies, as well as the Study of Heart and Renal Protection (SHARP) clinical trial, where statin/ezetimibe therapy was not associated with reduction in progression of kidney disease (9,11,27,28) However, total and LDL-C cholesterol levels were inversely associated with progression of kidney disease in patients with low levels of proteinuria, particularly those receiving statin therapy. The factors underlying this seemingly paradoxical relationship are unclear; participants in the lower cholesterol quartiles had more risk factors for progression and were more likely to be taking statins, perhaps reflecting a higher vascular risk.…”

Section: Discussionsupporting

confidence: 84%

“…Animal studies have shown development and progression of kidney damage in the setting of hyperlipidemia with increased glomerulosclerosis and tubulointerstitial damage (3)(4)(5)(6). In epidemiologic studies, the presence of dyslipidemia was associated with a higher risk of development of incident CKD in the general population (7)(8)(9). The association between dyslipidemia and progression of established kidney disease is not consistent in studies of diabetic (10) and nondiabetic (11)(12)(13)(14)(15) participants.…”

Section: Introductionmentioning

confidence: 99%

Relation of Serum Lipids and Lipoproteins with Progression of CKD

Rahman

Yang

Akkina

et al. 2014

Clinical Journal of the American Society of Nephrology

146

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Background and objectives Hyperlipidemia is common in patients with CKD. The objective of this study was to evaluate whether measures of plasma lipids and lipoproteins predict progression of kidney disease in patients with CKD.Design, setting, participants, & measurements Prospective cohort study in adults (n=3939) with CKD aged 21-74 years recruited between 2003 and 2008 and followed for a median of 4.1 years. At baseline, total cholesterol, triglycerides, very-low-density lipoprotein cholesterol (VLDL-C), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), apoA-I , apoB, and lipoprotein(a) [Lp(a)] were measured. The outcomes were composite end point of ESRD or 50% decline in eGFR from baseline (rate of change of GFR).Results Mean age of the study population was 58.2 years, and the mean GFR was 44.9 ml/min per 1.73 m 2 ; 48% of patients had diabetes. None of the lipid or lipoprotein measures was independently associated with risk of the composite end point or rate of change in GFR. However, there were significant (P=0.01) interactions by level of proteinuria. In participants with proteinuria,0.2 g/d, 1-SD higher LDL-C was associated with a 26% lower risk of the renal end point (hazard ratio [HR], 0.74; 95% confidence interval [95% CI], 0.59 to 0.92; P=0.01), and 1-SD higher total cholesterol was associated with a 23% lower risk of the renal end point (HR, 0.77; 95% CI, 0.62 to 0.96; P=0.02). In participants with proteinuria.0.2 g/d, neither LDL-C (HR, 0.98; 95% CI, 0.98 to 1.05) nor total cholesterol levels were associated with renal outcomes. Treatment with statins was reported in 55% of patients and was differential across lipid categories.Conclusions In this large cohort of patients with CKD, total cholesterol, triglycerides, VLDL-C, LDL-C, HDL-C, apoA-I, apoB, and Lp(a) were not independently associated with progression of kidney disease. There was an inverse relationship between LDL-C and total cholesterol levels and kidney disease outcomes in patients with low levels of proteinuria.

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“…In a recent study of 30 overweight patients and various nephropathies, a mean weight loss of 4.1% in the diet group was associated with a 31.2% reduction in proteinuria [7].…”

Section: Definition Of Chronic Kidney Diseasementioning

confidence: 95%

“…The deterioration is often attributed to systemic hypertension, proteinuria, hyperlipidaemia [3,4], and intra glomerular hypertension [5]. Smoking, obesity and anaemia are considered other risk factors for progression of chronic kidney disease [6][7][8].…”

Section: Definition Of Chronic Kidney Diseasementioning

confidence: 99%

Conservative Management of Chronic Renal Failure

Narula

Hooda

2007

Medical Journal Armed Forces India

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Plasma lipids and risk of developing renal dysfunction: The Atherosclerosis Risk in Communities Study

Abstract: High triglycerides and low HDL cholesterol, but not low-density lipoprotein cholesterol, predict an increased risk of renal dysfunction. The treatment of these lipid abnormalities may decrease the incidence of early renal disease.

Cited by 597 publications

References 44 publications

Relationship of the American Heart Association's Impact Goals (Life's Simple 7) With Risk of Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Cohort Study

Relationship of the American Heart Association's Impact Goals (Life's Simple 7) With Risk of Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Cohort Study

Relation of Serum Lipids and Lipoproteins with Progression of CKD

Conservative Management of Chronic Renal Failure

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