NDLI: Effect of low-density lipoprotein level and mortality in older incident statin-naïve hemodialysis patients

Content Provider	Springer Nature : BioMed Central
Author	Song, Je Hun Park, Eun Hee Bae, Jinsuk Kwon, Soon Hyo Cho, Jang-Hee Yu, Byung Chul Han, Miyeun Song, Sang Heon Ko, Gang-Jee Yang, Jae Won Chung, Sungjin Hong, Yu Ah Hyun, Young Youl Bae, Eunjin Sun, In O. Kim, Hyunsuk Hwang, Won Min Shin, Sung Joon Park, Woo Yeong Kim, Hyoungnae Yoo, Kyung Don
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.
Related Links	https://bmcnephrol.biomedcentral.com/counter/pdf/10.1186/s12882-023-03337-5.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14712369
DOI	10.1186/s12882-023-03337-5
Journal	BMC Nephrology
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2023-10-02
Access Restriction	Open
Subject Keyword	Nephrology Internal Medicine Low-density lipoproteins Hemodialysis Statins Chronic kidney disease All-cause mortality
Content Type	Text
Resource Type	Article
Subject	Nephrology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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