Association Between Serum High-Density Lipoprotein Cholesterol Levels and Progression of Chronic Kidney Disease: Results From the KNOW-CKD
- Authors
- Nam, Ki Heon; Chang, Tae Ik; Joo, Young Su; Kim, Joohwan; Lee, Sangmi; Lee, Changhyun; Yun, Hae-Ryong; Park, Jung Tak; Yoo, Tae-Hyun; Sung, Su Ah; Lee, Kyu-Beck; Oh, Kook-Hwan; Kim, Soo Wan; Lee, Joongyub; Kang, Shin-Wook; Choi, Kyu Hun; Ahn, Curie; Han, Seung Hyeok; Park, Soo Kyung; Kim, Jayeon; Chae, Dong Wan; Kim, Yong-Soo; Kim, Yeong Hoon; Kang, Sun Woo; Koo, Ho Seok; Chung, Wookyung; Jung, Jiyong
- Issue Date
- Mar-2019
- Publisher
- WILEY
- Keywords
- chronic kidney disease; high-density lipoprotein; high-density lipoprotein cholesterol; kidney; kidney disease progression
- Citation
- JOURNAL OF THE AMERICAN HEART ASSOCIATION, v.8, no.6
- Journal Title
- JOURNAL OF THE AMERICAN HEART ASSOCIATION
- Volume
- 8
- Number
- 6
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/1716
- DOI
- 10.1161/JAHA.118.011162
- ISSN
- 2047-9980
- Abstract
- Background-High-density lipoprotein cholesterol (HDL-C) levels are generally decreased in patients with chronic kidney disease (CKD). However, studies on the relationship between HDL-C and CKD progression are scarce. Methods and Results-We studied the association between serum HDL-C levels and the risk of CKD progression in 2168 participants of the KNOW-CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease). The primary outcome was the composite of a 50% decline in estimated glomerular filtration rate from baseline or end-stage renal disease. The secondary outcome was the onset of end-stage renal disease. During a median follow-up of 3.1 (interquartile range, 1.6-4.5) years, the primary outcome occurred in 335 patients (15.5%). In a fully adjusted Cox model, the lowest category with HDL-C of <30 mg/dL (hazard ratio, 2.21; 95% CI, 1.30-3.77) and the highest category with HDL-C of >= 60 mg/dL (hazard ratio, 2.05; 95% CI, 1.35-3.10) were associated with a significantly higher risk of the composite renal outcome, compared with the reference category with HDL-C of 50 to 59 mg/dL. This association remained unaltered in a time-varying Cox analysis. In addition, a fully adjusted cubic spline model with HDL-C being treated as a continuous variable yielded similar results. Furthermore, consistent findings were obtained in a secondary outcome analysis for the development of end-stage renal disease. Conclusions-A U-shaped association was observed between serum HDL-C levels and adverse renal outcomes in this large cohort of patients with CKD. Our findings suggest that both low and high serum HDL-C levels may be detrimental to patients with nondialysis CKD.
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