Association Between Serum High-Density Lipoprotein Cholesterol Levels and Progression of Chronic Kidney Disease

Results From the KNOW-CKD

the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease) Investigators

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article numbere011162
JournalJournal of the American Heart Association
Volume8
Issue number6
DOIs
Publication statusPublished - 2019 Mar 19

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Chronic Renal Insufficiency
HDL Cholesterol
Serum
Chronic Kidney Failure
Disease Progression
Kidney
Glomerular Filtration Rate
Proportional Hazards Models
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease) Investigators. / Association Between Serum High-Density Lipoprotein Cholesterol Levels and Progression of Chronic Kidney Disease : Results From the KNOW-CKD. In: Journal of the American Heart Association. 2019 ; Vol. 8, No. 6.
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title = "Association Between Serum High-Density Lipoprotein Cholesterol Levels and Progression of Chronic Kidney Disease: Results From the KNOW-CKD",
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.",
author = "{the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease) Investigators} and Nam, {Ki Heon} and Chang, {Tae Ik} and Joo, {Young Su} and Joohwan Kim and Sangmi Lee and Changhyun Lee and Yun, {Hae Ryong} and Park, {Jung Tak} and TaeHyun Yoo and Sung, {Su Ah} and Lee, {Kyu Beck} and Oh, {Kook Hwan} and Kim, {Soo Wan} and Joongyub Lee and Shin-Wook Kang and Choi, {Kyu Hun} and Curie Ahn and SeungHyeok Han",
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Association Between Serum High-Density Lipoprotein Cholesterol Levels and Progression of Chronic Kidney Disease : Results From the KNOW-CKD. / the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease) Investigators.

In: Journal of the American Heart Association, Vol. 8, No. 6, e011162, 19.03.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association Between Serum High-Density Lipoprotein Cholesterol Levels and Progression of Chronic Kidney Disease

T2 - Results From the KNOW-CKD

AU - the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease) Investigators

AU - Nam, Ki Heon

AU - Chang, Tae Ik

AU - Joo, Young Su

AU - Kim, Joohwan

AU - Lee, Sangmi

AU - Lee, Changhyun

AU - Yun, Hae Ryong

AU - Park, Jung Tak

AU - Yoo, TaeHyun

AU - Sung, Su Ah

AU - Lee, Kyu Beck

AU - Oh, Kook Hwan

AU - Kim, Soo Wan

AU - Lee, Joongyub

AU - Kang, Shin-Wook

AU - Choi, Kyu Hun

AU - Ahn, Curie

AU - Han, SeungHyeok

PY - 2019/3/19

Y1 - 2019/3/19

N2 - 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.

AB - 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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U2 - 10.1161/JAHA.118.011162

DO - 10.1161/JAHA.118.011162

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JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

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