Relation of Serum Lipids and Lipoproteins with Progression of CKD

• DOI: 10.2215/cjn.09320913
• Publication Date: 2014-05-16T06:41:59Z
• Authors: Mahboob Rahman; Wei Yang; Sanjeev Akkina; Arnold Alper; Amanda Hyre Anderson; Lawrence J. Appel; Jiang He; Dominic S. Raj; Jeffrey Schelling; Louise Strauss; Valerie Teal; Daniel J. Rader
• Keywords: Hyperlipidemia

Background and objectives Hyperlipidemia is common in patients with CKD. The objective of this study was to evaluate whether measures plasma lipids lipoproteins predict progression kidney disease Design, setting, participants, & measurements Prospective cohort adults (n=3939) CKD aged 21–74 years recruited between 2003 2008 followed for a median 4.1 years. At baseline, total cholesterol, triglycerides, very-low-density lipoprotein cholesterol (VLDL-C), LDL (LDL-C), HDL (HDL-C), apoA-I , apoB, lipoprotein(a) [Lp(a)] were measured. outcomes composite end point ESRD or 50% decline eGFR from baseline (rate change GFR). Results Mean age the population 58.2 years, mean GFR 44.9 ml/min per 1.73 m2; 48% had diabetes. None lipid independently associated risk rate GFR. However, there significant (P=0.01) interactions by level proteinuria. In participants proteinuria<0.2 g/d, 1-SD higher LDL-C 26% lower renal (hazard ratio [HR], 0.74; 95% confidence interval [95% CI], 0.59 0.92; P=0.01), 23% (HR, 0.77; CI, 0.62 0.96; P=0.02). proteinuria>0.2 neither 0.98; 0.98 1.05) nor levels outcomes. Treatment statins reported 55% differential across categories. Conclusions large CKD, VLDL-C, LDL-C, HDL-C, apoA-I, Lp(a) not disease. There an inverse relationship low