Tags

Type your tag names separated by a space and hit enter

Relation of serum lipids and lipoproteins with progression of CKD: The CRIC study.
Clin J Am Soc Nephrol. 2014 Jul; 9(7):1190-8.CJ

Abstract

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.

Links

PMC Free PDF

Authors+Show Affiliations

Rahman M
Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio; Mahboob.Rahman@uhhospitals.org.
Yang W
Center for Clinical Epidemiology and Biostatistics and.
Akkina S
Division of Nephrology, University of Illinois, Chicago, Illinois;
Alper A
Department of Epidemiology, Tulane University, New Orleans, Louisiana;
Anderson AH
Center for Clinical Epidemiology and Biostatistics and.
Appel LJ
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland;
He J
Department of Epidemiology, Tulane University, New Orleans, Louisiana;
Raj DS
Division of Nephrology, George Washington University, Washington, DC;
Schelling J
Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio; and.
Strauss L
University Hospitals Case Medical Center, Cleveland, Ohio.
Teal V
Center for Clinical Epidemiology and Biostatistics and.
Rader DJ
Division of Translational Medicine and Human Genetics, University of Pennsylvania, Philadelphia, Pennsylvania;
CRIC Study Investigators
No affiliation info available

MeSH

AdultAgedBiomarkersDisease ProgressionFemaleGlomerular Filtration RateHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHyperlipidemiasKidneyKidney Failure, ChronicLipidsLipoproteinsMaleMiddle AgedProspective StudiesProtective FactorsProteinuriaRenal Insufficiency, ChronicRisk FactorsYoung Adult

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24832097

Citation

Rahman, Mahboob, et al. "Relation of Serum Lipids and Lipoproteins With Progression of CKD: the CRIC Study." Clinical Journal of the American Society of Nephrology : CJASN, vol. 9, no. 7, 2014, pp. 1190-8.
Rahman M, Yang W, Akkina S, et al. Relation of serum lipids and lipoproteins with progression of CKD: The CRIC study. Clin J Am Soc Nephrol. 2014;9(7):1190-8.
Rahman, M., Yang, W., Akkina, S., Alper, A., Anderson, A. H., Appel, L. J., He, J., Raj, D. S., Schelling, J., Strauss, L., Teal, V., & Rader, D. J. (2014). Relation of serum lipids and lipoproteins with progression of CKD: The CRIC study. Clinical Journal of the American Society of Nephrology : CJASN, 9(7), 1190-8. https://doi.org/10.2215/CJN.09320913
Rahman M, et al. Relation of Serum Lipids and Lipoproteins With Progression of CKD: the CRIC Study. Clin J Am Soc Nephrol. 2014;9(7):1190-8. PubMed PMID: 24832097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation of serum lipids and lipoproteins with progression of CKD: The CRIC study. AU - Rahman,Mahboob, AU - Yang,Wei, AU - Akkina,Sanjeev, AU - Alper,Arnold, AU - Anderson,Amanda Hyre, AU - Appel,Lawrence J, AU - He,Jiang, AU - Raj,Dominic S, AU - Schelling,Jeffrey, AU - Strauss,Louise, AU - Teal,Valerie, AU - Rader,Daniel J, AU - ,, Y1 - 2014/05/15/ PY - 2014/5/17/entrez PY - 2014/5/17/pubmed PY - 2015/4/7/medline KW - chronic kidney disease KW - lipids KW - progression of chronic renal failure SP - 1190 EP - 8 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 9 IS - 7 N2 - 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. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/24832097/full_citation DB - PRIME DP - Unbound Medicine ER -