Time-dependent lipid profile inversely associates with mortality in hemodialysis patients - independent of inflammation/malnutrition.

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Serval ID
serval:BIB_E998B78F735B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Time-dependent lipid profile inversely associates with mortality in hemodialysis patients - independent of inflammation/malnutrition.
Journal
Journal of internal medicine
Author(s)
Ebert T., Qureshi A.R., Lamina C., Fotheringham J., Froissart M., Eckardt K.U., Wheeler D.C., Floege J., Kronenberg F., Stenvinkel P.
ISSN
1365-2796 (Electronic)
ISSN-L
0954-6820
Publication state
Published
Issued date
10/2021
Peer-reviewed
Oui
Volume
290
Number
4
Pages
910-921
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Patients with end-stage kidney disease have an extremely high cardiovascular mortality rate, but there is a paradoxical relationship between lipid profile and survival in haemodialysis patients. To investigate whether inflammation/malnutrition confounds the associations between lipids and mortality, we studied a full lipid profile comprising of five clinically well-established lipid parameters and its associations with mortality in a large, multinational European cohort with a median follow-up >3 years.
The association between quartiles of total, high-density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL) cholesterol, as well as triglyceride, levels and the end-points of all-cause, cardiovascular and non-cardiovascular mortality was assessed in a cohort of 5,382 incident, adult haemodialysis patients from >250 Fresenius Medical Care dialysis centres out of 14 participating countries using baseline and time-dependent Cox models. Analyses were fully adjusted and stratified for inflammation/malnutrition status and other patient-level variables.
Time-dependent quartiles of total, HDL, non-HDL and LDL cholesterol were inversely associated with the hazard for all-cause, cardiovascular and non-cardiovascular mortality. Compared with the lowest quartile of the respective lipid parameter, hazard ratios of other quartiles were <0.86. Similar, albeit weaker, associations were found with baseline lipid profile and mortality. Neither time-dependent nor baseline associations between lipid profile and mortality were affected by inflammation/malnutrition, statin use or geography.
Baseline and time-dependent lipid profile are inversely associated with mortality in a large, multicentre cohort of incident haemodialysis patients. Inflammation/malnutrition is not a confounder nor effect modificator of the associations between lipid profile and mortality in European haemodialysis patients.
Keywords
Cardiovascular Diseases/mortality, Cholesterol, HDL, Cholesterol, LDL, Humans, Inflammation, Lipids/blood, Malnutrition, Renal Dialysis, Risk Factors, albumin, cholesterol, chronic kidney disease, haemodialysis, inflammation, lipid profile, mortality
Pubmed
Web of science
Open Access
Yes
Create date
25/05/2021 12:18
Last modification date
21/11/2022 8:25
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