Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients
Abstract Background This study aimed to analyze low-density lipoprotein cholesterol (LDL-C) levels and their relationship with mortality in order to identify the appropriate lipid profile for older Korean hemodialysis patients. Methods We enrolled a total of 2,732 incident hemodialysis patients aged...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12882-023-03337-5 |
| _version_ | 1797453645921386496 |
|---|---|
| author | Je Hun Song Eun Hee Park Jinsuk Bae Soon Hyo Kwon Jang-Hee Cho Byung Chul Yu Miyeun Han Sang Heon Song Gang-Jee Ko Jae Won Yang Sungjin Chung Yu Ah Hong Young Youl Hyun Eunjin Bae In O. Sun Hyunsuk Kim Won Min Hwang Sung Joon Shin Woo Yeong Park Hyoungnae Kim Kyung Don Yoo |
| author_facet | Je Hun Song Eun Hee Park Jinsuk Bae Soon Hyo Kwon Jang-Hee Cho Byung Chul Yu Miyeun Han Sang Heon Song Gang-Jee Ko Jae Won Yang Sungjin Chung Yu Ah Hong Young Youl Hyun Eunjin Bae In O. Sun Hyunsuk Kim Won Min Hwang Sung Joon Shin Woo Yeong Park Hyoungnae Kim Kyung Don Yoo |
| author_sort | Je Hun Song |
| collection | DOAJ |
| description | Abstract Background This study aimed to analyze low-density lipoprotein cholesterol (LDL-C) levels and their relationship with mortality in order to identify the appropriate lipid profile for older Korean hemodialysis patients. Methods We enrolled a total of 2,732 incident hemodialysis patients aged > 70 years from a retrospective cohort of the Korean Society of Geriatric Nephrology from 2010 Jan to 2017 Dec, which included 17 academic hospitals in South Korea. Of these patients, 1,709 were statin-naïve, and 1,014 were analyzed after excluding those with missing LDL-C level data. We used multivariate Cox regression analysis to select risk factors from 20 clinical variables among the LDL-C groups. Results The mean age of the entire patient population was 78 years, with no significant differences in age between quartiles Q1 to Q4. However, the proportion of males decreased as the quartiles progressed towards Q4 (p < 0.001). The multivariate Cox regression analysis, which included all participants, showed that low LDL-C levels were associated with all-cause mortality. In the final model, compared to Q1, the hazard ratios (95% confidence interval) were 0.77 (0.620–0.972; p = 0.027), 0.85 (0.676–1.069; p = 0.166), and 0.65 (0.519–0.824; p < 0.001) for Q2, Q3, and Q4, respectively, after adjusting for covariates, such as conventional and age-specific risk factors. The final model demonstrated that all-cause mortality increased as LDL-C levels decreased, as confirmed by a restrictive cubic spline plot. Conclusions In older hemodialysis patients who had not previously received dyslipidemia treatment, elevated LDL-C levels were not associated with increased all-cause mortality. Intriguingly, lower LDL-C levels appear to be associated with an unfavorable effect on all-cause mortality among high-risk hemodialysis patients. |
| first_indexed | 2024-03-09T15:25:49Z |
| format | Article |
| id | doaj.art-ea2dea770b78493b9c51cf22d082c5bb |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-09T15:25:49Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-ea2dea770b78493b9c51cf22d082c5bb2023-11-26T12:35:22ZengBMCBMC Nephrology1471-23692023-10-0124111110.1186/s12882-023-03337-5Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patientsJe Hun Song0Eun Hee Park1Jinsuk Bae2Soon Hyo Kwon3Jang-Hee Cho4Byung Chul Yu5Miyeun Han6Sang Heon Song7Gang-Jee Ko8Jae Won Yang9Sungjin Chung10Yu Ah Hong11Young Youl Hyun12Eunjin Bae13In O. Sun14Hyunsuk Kim15Won Min Hwang16Sung Joon Shin17Woo Yeong Park18Hyoungnae Kim19Kyung Don Yoo20Division of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of MedicineDivision of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of MedicineDivision of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of MedicineDivision of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul HospitalDivision of Nephrology, Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of MedicineDivision of Nephrology, Department of Internal Medicine, Soonchunhyang University Bucheon HospitalDivision of Nephrology, Department of Internal Medicine, National Medical CenterDivision of Nephrology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of MedicineDivision of Nephrology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of MedicineDivision of Nephrology, Department of Internal Medicine, Yonsei University Wonju College of MedicineDivision of Nephrology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Nephrology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDivision of Nephrology, Department of Internal Medicine, Gyeongsang National University Changwon HospitalDivision of Nephrology, Department of Internal Medicine, Presbyterian Medical CenterDivision of Nephrology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of MedicineDivision of Nephrology, Department of Internal Medicine, Konyang University HospitalDivision of Nephrology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University School of MedicineDivision of Nephrology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of MedicineDivision of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul HospitalDivision of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of MedicineAbstract Background This study aimed to analyze low-density lipoprotein cholesterol (LDL-C) levels and their relationship with mortality in order to identify the appropriate lipid profile for older Korean hemodialysis patients. Methods We enrolled a total of 2,732 incident hemodialysis patients aged > 70 years from a retrospective cohort of the Korean Society of Geriatric Nephrology from 2010 Jan to 2017 Dec, which included 17 academic hospitals in South Korea. Of these patients, 1,709 were statin-naïve, and 1,014 were analyzed after excluding those with missing LDL-C level data. We used multivariate Cox regression analysis to select risk factors from 20 clinical variables among the LDL-C groups. Results The mean age of the entire patient population was 78 years, with no significant differences in age between quartiles Q1 to Q4. However, the proportion of males decreased as the quartiles progressed towards Q4 (p < 0.001). The multivariate Cox regression analysis, which included all participants, showed that low LDL-C levels were associated with all-cause mortality. In the final model, compared to Q1, the hazard ratios (95% confidence interval) were 0.77 (0.620–0.972; p = 0.027), 0.85 (0.676–1.069; p = 0.166), and 0.65 (0.519–0.824; p < 0.001) for Q2, Q3, and Q4, respectively, after adjusting for covariates, such as conventional and age-specific risk factors. The final model demonstrated that all-cause mortality increased as LDL-C levels decreased, as confirmed by a restrictive cubic spline plot. Conclusions In older hemodialysis patients who had not previously received dyslipidemia treatment, elevated LDL-C levels were not associated with increased all-cause mortality. Intriguingly, lower LDL-C levels appear to be associated with an unfavorable effect on all-cause mortality among high-risk hemodialysis patients.https://doi.org/10.1186/s12882-023-03337-5Low-density lipoproteinsHemodialysisStatinsChronic kidney diseaseAll-cause mortality |
| spellingShingle | Je Hun Song Eun Hee Park Jinsuk Bae Soon Hyo Kwon Jang-Hee Cho Byung Chul Yu Miyeun Han Sang Heon Song Gang-Jee Ko Jae Won Yang Sungjin Chung Yu Ah Hong Young Youl Hyun Eunjin Bae In O. Sun Hyunsuk Kim Won Min Hwang Sung Joon Shin Woo Yeong Park Hyoungnae Kim Kyung Don Yoo Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients BMC Nephrology Low-density lipoproteins Hemodialysis Statins Chronic kidney disease All-cause mortality |
| title | Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients |
| title_full | Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients |
| title_fullStr | Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients |
| title_full_unstemmed | Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients |
| title_short | Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients |
| title_sort | effect of low density lipoprotein level and mortality in older incident statin naive hemodialysis patients |
| topic | Low-density lipoproteins Hemodialysis Statins Chronic kidney disease All-cause mortality |
| url | https://doi.org/10.1186/s12882-023-03337-5 |
| work_keys_str_mv | AT jehunsong effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT eunheepark effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT jinsukbae effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT soonhyokwon effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT jangheecho effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT byungchulyu effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT miyeunhan effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT sangheonsong effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT gangjeeko effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT jaewonyang effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT sungjinchung effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT yuahhong effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT youngyoulhyun effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT eunjinbae effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT inosun effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT hyunsukkim effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT wonminhwang effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT sungjoonshin effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT wooyeongpark effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT hyoungnaekim effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients AT kyungdonyoo effectoflowdensitylipoproteinlevelandmortalityinolderincidentstatinnaivehemodialysispatients |