NDLI: Association of cholesterol levels with mortality and cardiovascular events among patients with CKD and different amounts of proteinuria.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Chen, Szu-Chia Hung, Chi-Chih Tsai, Yi-Chun Huang, Jiun-Chi Kuo, Mei-Chuan Lee, Jia-Jung Chiu, Yi-Wen Chang, Jer-Ming Hwang, Shang-Jyh Chen, Hung-Chun
Spatial Coverage	Taiwan
Description	Country affiliation: Taiwan Author Affiliation: Chen SC ( Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan)
Abstract	BACKGROUND AND OBJECTIVES: Malnutrition and/or inflammation may modify the risk relationship of total cholesterol with cardiovascular disease in CKD patients. However, it is unclear whether the relationship of total cholesterol with cardiovascular events and mortality varies by proteinuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This study enrolled 3303 patients with CKD stages 3-5 from a medical center and a regional hospital between November of 2002 and May of 2009 and followed the patients until July of 2010. RESULTS: During a median 2.8-year follow-up, there were 471 (14.3%) deaths and 545 (16.5%) cardiovascular events. In an adjusted Cox model, the two highest quartiles of total cholesterol (hazard ratio, 1.90; 95% confidence interval, 1.16 to 3.13 and hazard ratio, 2.00; 95% confidence interval, 1.18 to 3.39 versus quartile 1, respectively) were associated with a significant higher risk of all-cause mortality in patients with urine protein-to-creatinine ratio<1 g/g (n=1535), but this higher risk was not seen in those patients with urine protein-to-creatinine ratio ≥ 1 g/g (n=1768; hazard ratio, 0.75; 95% confidence interval, 0.53 to 1.07 and hazard ratio, 0.70; 95% confidence interval, 0.49 to 1.02 versus quartile 1, respectively). The interaction between total cholesterol and proteinuria with all-cause mortality was significant (interaction, P=0.05). However, the relationship between total cholesterol and cardiovascular events did not significantly differ by proteinuria (interaction, P=0.91). CONCLUSIONS: The association between cholesterol and mortality is different among patients with different levels of proteinuria. Large-scale clinical trials to evaluate the mortality benefit should specifically target lowering hypercholesterolemia in CKD patients with different levels of proteinuria.
File Format	HTM / HTML
ISSN	15559041
e-ISSN	1555905X
DOI	10.2215/CJN.02350213
Journal	Clinical Journal of the American Society of Nephrology
Issue Number	11
Volume Number	8
Language	English
Publisher	American Society of Nephrology
Publisher Date	2013-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Cardiovascular Diseases Prognosis Prospective Studies Comparative Study Biological Markers Blood Time Factors Diagnosis Severity Of Illness Index Urine Creatinine Renal Insufficiency, Chronic Mortality Risk Factors Proportional Hazards Models Discipline Nephrology Academic Medical Centers Cholesterol Taiwan Multicenter Study Proteinuria
Content Type	Text
Resource Type	Article
Subject	Transplantation Critical Care and Intensive Care Medicine Nephrology Epidemiology

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