Non-High-Density Lipoprotein Cholesterol and Progression of Chronic Kidney Disease: Results from the KNOW-CKD Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Collection from Participants
2.3. Exposure and Study Outcome
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Association of nHDL with Renal Outcomes in Patients with Non-Dialysis CKD
3.3. Sensitivity Analyses
3.4. Subgroup Analyses
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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nHDL Level | p Value | |||
---|---|---|---|---|
T1 | T2 | T3 | ||
Follow-up duration (year) | 6.334 ± 2.493 | 6.320 ± 2.533 | 6.234 ± 2.538 | 0.720 |
Age (year) | 55.098 ± 12.452 | 53.478 ± 11.897 | 52.620 ± 12.314 | 0.001 |
Male | 465 (64.1) | 434 (60.8) | 422 (59.2) | 0.144 |
Age-adjusted CCI | 0.001 | |||
0–3 | 330 (45.5) | 398 (55.7) | 394 (55.3) | |
4–5 | 232 (32.0) | 193 (27.0) | 207 (29.0) | |
6–7 | 132 (18.2) | 105 (14.7) | 97 (13.6) | |
≥8 | 31 (4.3) | 18 (2.5) | 15 (2.1) | |
Primary cause of CKD | 0.117 | |||
DM | 215 (29.7) | 155 (21.7) | 175 (24.6) | |
HTN | 139 (19.2) | 137 (19.2) | 150 (21.1) | |
GN | 211 (29.1) | 247 (34.6) | 227 (31.9) | |
TID | 4 (0.6) | 5 (0.7) | 4 (0.6) | |
PKD | 107 (14.8) | 119 (16.7) | 114 (16.0) | |
Others | 49 (6.8) | 51 (7.1) | 42 (5.9) | |
Smoking history | 0.151 | |||
Non-smoker | 361 (49.8) | 395 (55.3) | 392 (55.1) | |
Ex-smoker | 118 (16.3) | 108 (15.1) | 115 (16.2) | |
Current smoker | 246 (33.9) | 211 (29.6) | 204 (28.7) | |
Medication | ||||
ACEIs/ARBs | 214 (29.5) | 197 (27.6) | 219 (30.7) | 0.425 |
Diuretic use | 237 (32.7) | 210 (29.4) | 239 (33.5) | 0.212 |
Anti-HTN drugs ≥ 3 | 214 (29.5) | 197 (27.6) | 219 (30.7) | 0.425 |
Statins | 509 (70.2) | 343 (48.0) | 266 (37.3) | <0.001 |
BMI (kg/m2) | 24.140 ± 3.277 | 24.583 ± 3.206 | 25.100 ± 3.681 | <0.001 |
Waist circumference (cm) | 86.518 ± 9.543 | 87.410 ± 9.470 | 88.659 ± 10.089 | <0.001 |
SBP (mmHg) | 125.552 ± 15.070 | 128.585 ± 16.716 | 129.361 ± 16.530 | <0.001 |
DBP (mmHg) | 74.724 ± 10.425 | 77.742 ± 10.952 | 78.303 ± 11.567 | <0.001 |
Laboratory findings | ||||
Hemoglobin (g/dL) | 12.520 ± 2.019 | 12.970 ± 2.000 | 13.031 ± 2.010 | <0.001 |
Albumin (g/dL) | 4.188 ± 0.353 | 4.205 ± 0.371 | 4.132 ± 0.530 | 0.010 |
Total cholesterol (mg/dL) | 138.422 ± 21.093 | 169.807 ± 16.377 | 214.798 ± 30.740 | <0.001 |
HDL-C (mg/dL) | 50.692 ± 17.316 | 48.418 ± 14.229 | 48.592 ± 14.407 | 0.013 |
LDL-C (mg/dL) | 68.828 ± 15.342 | 94.705 ± 16.829 | 127.746 ± 27.669 | <0.001 |
TG (mg/dL) | 117.327 ± 58.870 | 152.076 ± 77.792 | 204.278 ± 125.992 | <0.001 |
Fasting glucose (mg/dL) | 107.427 ± 33.661 | 110.925 ± 41.189 | 115.025 ± 44.121 | 0.001 |
hs-CRP (mg/dL) | 0.500 (0.200, 1.400) | 0.600 (0.210, 1.700) | 0.800 (0.300, 1.900) | 0.449 |
Spot urine ACR (mg/g) | 331.017 (80.954, 891.067) | 312.364 (63.343, 950.315) | 426.526 (91.296, 1489.556) | <0.001 |
Creatinine (mg/dL) | 1.925 ± 1.220 | 1.768 ± 1.133 | 1.767 ± 1.103 | 0.015 |
eGFR (mL/min/1.73 m2) | 47.145 ± 28.686 | 52.215 ± 30.834 | 51.965 ± 30.823 | 0.001 |
CKD stages | 0.111 | |||
Stage 1 | 93 (12.8) | 130 (18.2) | 125 (17.5) | |
Stage 2 | 132 (18.2) | 135 (18.9) | 140 (19.6) | |
Stage 3a | 114 (15.7) | 117 (16.4) | 122 (17.1) | |
Stage 3b | 161 (22.2) | 149 (20.9) | 143 (20.1) | |
Stage 4 | 169 (23.3) | 146 (20.4) | 141 (19.8) | |
Stage 5 | 56 (7.7) | 37 (5.2) | 42 (5.9) |
NHDL | Events, n (%) | Model 1 | Model 2 | Model 3 | Model 4 | |||||
---|---|---|---|---|---|---|---|---|---|---|
HR (95% CIs) | p Value | HR (95% CIs) | p Value | HR (95% CIs) | p Value | HR (95% CIs) | p Value | |||
Composite renal event | T1 | 295 (40.7) | 1.302 (1.084, 1.564) | 0.005 | 1.224 (1.033, 1.452) | 0.020 | 1.178 (0.982, 1.414) | 0.077 | 1.309 (1.074, 1.595) | 0.008 |
T2 | 243 (34.0) | Reference | Reference | Reference | Reference | |||||
T3 | 278 (39.0) | 1.207 (1.000, 1.456) | 0.050 | 1.213 (1.021, 1.440) | 0.028 | 1.216 (1.015, 1.457) | 0.033 | 1.272 (1.040, 1.556) | 0.019 |
NHDL | Events, n (%) | Model 1 | Model 2 | Model 3 | Model 4 | |||||
---|---|---|---|---|---|---|---|---|---|---|
HR (95% CIs) | p Value | HR (95% CIs) | p Value | HR (95% CIs) | p Value | HR (95% CIs) | p Value | |||
Decline of renal function | T1 | 198 (27.3) | 1.162 (0.932, 1.448) | 0.182 | 1.144 (0.933, 1.403) | 0.197 | 1.055 (0.846, 1.316) | 0.634 | 1.110 (0.882, 1.398) | 0.373 |
T2 | 174 (24.4) | Reference | Reference | Reference | Reference | |||||
T3 | 197 (27.6) | 1.148 (0.917, 1.436) | 0.228 | 1.193 (0.973, 1.463) | 0.089 | 1.209 (0.976, 1.498) | 0.082 | 1.002 (0.791, 1.271) | 0.984 | |
Initiation of RRT | T1 | 226 (31.2) | 1.293 (1.047, 1.597) | 0.017 | 1.207 (0.993, 1.468) | 0.058 | 1.139 (0.924, 1.404) | 0.224 | 1.151 (0.915, 1.449) | 0.231 |
T2 | 184 (25.8) | Reference | Reference | Reference | Reference | |||||
T3 | 214 (30.0) | 1.247 (1.005, 1.546) | 0.045 | 1.228 (1.008, 1.495) | 0.041 | 1.224 (0.995, 1.506) | 0.056 | 1.281 (1.014, 1.619) | 0.038 |
NHDL | Model 1 | Model 2 | Model 3 | Model 4 | |||||
---|---|---|---|---|---|---|---|---|---|
HR (95% CIs) | p value | HR (95% CIs) | p value | HR (95% CIs) | p value | HR (95% CIs) | p value | ||
Composite renal event | T1 | 1.240 (1.047, 1.467) | 0.013 | 1.224 (1.033, 1.451) | 0.019 | 1.178 (0.976, 1.432) | 0.088 | 1.309 (1.051, 1.630) | 0.016 |
T2 | Reference | Reference | Reference | Reference | |||||
T3 | 1.209 (1.018, 1.437) | 0.031 | 1.213 (1.021, 1.441) | 0.028 | 1.216 (1.010, 1.464) | 0.039 | 1.273 (1.013, 1.598) | 0.038 | |
Decline renal function | T1 | 1.139 (0.930, 1.395) | 0.207 | 1.144 (0.933, 1.402) | 0.196 | 1.055 (0.843, 1.321) | 0.640 | 1.111 (0.883, 1.396) | 0.369 |
T2 | Reference | Reference | Reference | Reference | |||||
T3 | 1.195 (0.974, 1.466) | 0.087 | 1.193 (0.973, 1.464) | 0.090 | 1.209 (0.972, 1.504) | 0.088 | 1.002 (0.780, 1.288) | 0.985 | |
Initiation of RRT | T1 | 1.236 (1.018, 1.501) | 0.032 | 1.207 (0.993, 1.468) | 0.059 | 1.139 (0.915, 1.417) | 0.243 | 1.151 (0.887, 1.484) | 0.290 |
T2 | Reference | Reference | Reference | Reference | |||||
T3 | 1.219 (1.001, 1.485) | 0.049 | 1.228 (1.008, 1.495) | 0.041 | 1.224 (0.991, 1.513) | 0.061 | 1.282 (0.977, 1.683) | 0.073 |
NHDL | Events, n (%) | Unadjusted HR (95% CIs) | p for Interaction | Adjusted HR (95% CIs) | p for Interaction | |
---|---|---|---|---|---|---|
Age < 60 years | T1 | 173 (40.7) | 1.255 (1.011, 1.556) | 0.720 | 1.256 (0.972, 1.624) | 0.157 |
T2 | 159 (33.3) | Reference | Reference | |||
T3 | 188 (39.0) | 1.270 (1.028, 1.569) | 1.320 (1.024, 1.701) | |||
Age ≥ 60 years | T1 | 122 (40.7) | 1.168 (0.885, 1.543) | 1.396 (1.010, 1.929) | ||
T2 | 84 (35.6) | Reference | Reference | |||
T3 | 90 (39.0) | 1.087 (0.807, 1.464) | 1.1685, 0.817, 1.670) | |||
Male | T1 | 174 (37.4) | 1.084 (0.872, 1.348) | 0.153 | 1.047 (0.807, 1.359) | 0.007 |
T2 | 151 (34.8) | Reference | Reference | |||
T3 | 162 (38.4) | 1.145 (0.917, 1.430) | 1.453 (1.114, 1.895) | |||
Female | T1 | 121 (46.5) | 1.528 (1.165, 2.004) | 1.506 (1.086, 2.088) | ||
T2 | 92 (32.9) | Reference | Reference | |||
T3 | 116 (39.9) | 1.315 (1.000, 1.729) | 0.993 (0.710, 1.388) | |||
BMI < 23 kg/m2 | T1 | 111 (41.4) | 1.252 (0.936, 1.675) | 0.898 | 0.794 (0.558, 1.129) | 0.035 |
T2 | 77 (34.7) | Reference | Reference | |||
T3 | 82 (39.6) | 1.289 (0.944, 1.760) | 0.980 (0.673, 1.425) | |||
BMI ≥ 23 kg/m2 | T1 | 183 (40.6) | 1.233 (0.999, 1.522) | 1.562 (1.217, 2.005) | ||
T2 | 164 (33.7) | Reference | Reference | |||
T3 | 196 (39.0) | 1.186 (0.963, 1.459) | 1.433 (1.120, 1.835) | |||
eGFR ≥ 45 mL/min/1.73 m2 | T1 | 51 (16.2) | 1.036 (0.707, 1.520) | 0.585 | 0.994 (0.651, 1.518) | 0.011 |
T2 | 54 (14.8) | Reference | Reference | |||
T3 | 60 (16.6) | 1.094 (0.757, 1.580) | 0.736 (0.478, 1.133) | |||
eGFR < 45 mL/min/1.73 m2 | T1 | 244 (59.5) | 1.183 (0.978, 1.431) | 1.313 (1.046, 1.648) | ||
T2 | 189 (54.2) | Reference | Reference | |||
T3 | 218 (62.1) | 1.353 (1.113, 1.644) | 1.426 (1.131, 1.797) | |||
Spot urine ACR < 300 mg/g | T1 | 88 (26.4) | 1.486 (1.073, 2.057) | 0.173 | 1.400 (0.951, 2.059) | 0.800 |
T2 | 62 (18.4) | Reference | Reference | |||
T3 | 57 (19.6) | 1.031 (0.720, 1.478) | 1.229 (0.824, 1.833) | |||
Spot urine ACR ≥ 300 mg/g | T1 | 202 (55.5) | 1.157 (0.945, 1.416) | 1.259 (0.993, 1.593) | ||
T2 | 176 (49.9) | Reference | Reference | |||
T3 | 213 (53.4) | 1.161 (0.951, 1.418) | 1.290 (1.015, 1.639) |
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Suh, S.H.; Oh, T.R.; Choi, H.S.; Kim, C.S.; Bae, E.H.; Ma, S.K.; Oh, K.-H.; Hyun, Y.Y.; Sung, S.; Kim, S.W., on behalf of the Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease (KNOW-CKD) Investigators. Non-High-Density Lipoprotein Cholesterol and Progression of Chronic Kidney Disease: Results from the KNOW-CKD Study. Nutrients 2022, 14, 4704. https://doi.org/10.3390/nu14214704
Suh SH, Oh TR, Choi HS, Kim CS, Bae EH, Ma SK, Oh K-H, Hyun YY, Sung S, Kim SW on behalf of the Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease (KNOW-CKD) Investigators. Non-High-Density Lipoprotein Cholesterol and Progression of Chronic Kidney Disease: Results from the KNOW-CKD Study. Nutrients. 2022; 14(21):4704. https://doi.org/10.3390/nu14214704
Chicago/Turabian StyleSuh, Sang Heon, Tae Ryom Oh, Hong Sang Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Kook-Hwan Oh, Young Youl Hyun, Suah Sung, and Soo Wan Kim on behalf of the Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease (KNOW-CKD) Investigators. 2022. "Non-High-Density Lipoprotein Cholesterol and Progression of Chronic Kidney Disease: Results from the KNOW-CKD Study" Nutrients 14, no. 21: 4704. https://doi.org/10.3390/nu14214704
APA StyleSuh, S. H., Oh, T. R., Choi, H. S., Kim, C. S., Bae, E. H., Ma, S. K., Oh, K. -H., Hyun, Y. Y., Sung, S., & Kim, S. W., on behalf of the Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease (KNOW-CKD) Investigators. (2022). Non-High-Density Lipoprotein Cholesterol and Progression of Chronic Kidney Disease: Results from the KNOW-CKD Study. Nutrients, 14(21), 4704. https://doi.org/10.3390/nu14214704