scholarly journals Indoxyl Sulfate and High-density Lipoprotein Cholesterol in Early Stages of Chronic Kidney Disease

2019 ◽  
Author(s):  
Li Wang ◽  
Fangfang Xiang ◽  
Jun Ji ◽  
Jianzhou Zou ◽  
Yunqin Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
High Density ◽  
Indoxyl Sulfate ◽  
Lipoprotein Cholesterol ◽  
Ckd Stage

Abstract Background: High indoxyl sulfate (IS) levels and low high-density lipoprotein cholesterol (HDL-c) levels are both risk factors of cardiovascular diseases (CVD) in chronic kidney disease (CKD) patients, the connection between which has not been clearly clarified. This study aimed to explore the relationship between IS and HDL-c levels in early stages of CKD population. Methods: Patients of CKD stage 1-3 were enrolled in this cross-sectional study. Correlations between HDL-c and IS were investigated among various clinicopathological variables.Results: A total of 205 CKD patients (96 men) with a mean age of 43.3 years old were included in this research. There were 96 patients (46 men) in CKD stage1 and 109 (50 men) in CKD stage 2 or stage 3. IS levels were significantly higher in CKD 2+3 group (1.50±1.74μg/ml vs 0.94±0.66μg/ml, p=0.007), while HCL-c levels were lower (1.19±0.39mmol/L vs 1.33±0.45 mmol/L, p=0.017) compared to CKD 1 group. Among all the patients, a negative correlation was observed between IS and HDL-c levels (r=-0.244, p=0.001). IS level was an independent risk factor for low HDL-c (<1.04mmol/L) incidence even after controlling for potential confounders (OR=1.63, 95% CI: 1.11-2.39, p=0.013). IS and HDL-c were both risk factors for predicting CKD stage 3. Conclusions: Metabolic disorder of HDL-c occurs in early CKD stages, probably attributed by increased IS level. Early management of dyslipidemia and uremic toxin retention is important for delaying disease progression and preventing cardiovascular events. Keywords: Indoxyl sulfate, High-density lipoprotein cholesterol, Chronic kidney disease, Cardiovascular disease, Lipids

scholarly journals High-density lipoprotein cholesterol and causes of death in chronic kidney disease

2018 ◽  
Vol 12 (4) ◽  
pp. 1061-1071.e7 ◽  
Author(s):  
Sankar D. Navaneethan ◽  
Jesse D. Schold ◽  
Carl P. Walther ◽  
Susana Arrigain ◽  
Stacey E. Jolly ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Causes Of Death ◽  
Density Lipoprotein ◽  
High Density ◽  
Lipoprotein Cholesterol

scholarly journals Inflammation Alters Relationship Between High‐Density Lipoprotein Cholesterol and Cardiovascular Risk in Patients With Chronic Kidney Disease: Results From KNOW‐CKD

2021 ◽  
Author(s):  
Jae Young Kim ◽  
Jung Tak Park ◽  
Hyung Woo Kim ◽  
Tae‐Ik Chang ◽  
Ea Wha Kang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Cardiovascular Events ◽  
Primary Outcome ◽  
Density Lipoprotein ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Major Adverse Cardiovascular Events

Background The function of high‐density lipoprotein can change from protective to proatherosclerotic under inflammatory conditions. Herein, we studied whether inflammation could modify the relationship between high‐density lipoprotein level and risk of adverse outcomes in patients with chronic kidney disease . Methods and Results In total, 1864 patients from the prospective KNOW‐CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) were enrolled. The main predictor was high‐density lipoprotein cholesterol (HDL‐C) level. Presence of inflammation was defined by hs‐CRP (high‐sensitivity C‐reactive protein) level of ≥1.0 mg/L. The primary outcome was extended major adverse cardiovascular events. During 9231.2 person‐years of follow‐up, overall incidence of the primary outcome was 15.8 per 1000 person‐years. In multivariable Cox analysis after adjusting for confounders, HDL‐C level was not associated with the primary outcome. There was a significant interaction between the inflammatory status and HDL‐C for risk of extended major adverse cardiovascular events ( P =0.003). In patients without inflammation, the hazard ratios (HRs) (95% CIs) for HDL‐C levels <40, 50 to 59, and ≥60 mg/dL were 1.10 (0.50–1.82), 0.95 (0.50–1.82), and 0.42 (0.19–0.95), respectively, compared with HDL‐C of 40 to 49 mg/dL. However, the significant association for HDL‐C ≥60 mg/dL was not seen after Bonferroni correction. In patients with inflammation, we observed a trend toward increased risk of extended major adverse cardiovascular events in higher HDL‐C groups (HRs [95% CIs], 0.73 [0.37–1.43], 1.24 [0.59–2.61], and 1.56 [0.71–3.45], respectively), but without statistical significance. Conclusions The association between HDL‐C level and adverse cardiovascular outcomes showed reverse trends based on inflammation status in Korean patients with chronic kidney disease. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01630486.

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