Background and aims: The prognostic role of LDL in non-dialysis chronic kidney disease (CKD) is still undefined. We addressed this question in a multicenter prospective study including patients referred to nephrologist for management. Methods and results: 1306 patients with CKD stage III-V were studied at basal visit in 79 Italian nephrology clinics in 2004-2006, and then followed for survival analyses. Study endpoints were incident cardiovascular -CV events (fatal and major non-fatal) and renal events (start of renal replacement therapy or eGFR halving). Mean age was 67.6 ± 11.8 years, male 65%, diabetes 25%, CV disease 27%, and eGFR 35.8 ± 12.5 mL/min/1.73 m2. LDL was 119 ± 40 mg/dL, with high levels in 50.1% and 82.8% defined on the basis of the individual CV risk profile estimated according to ATPIII 2001 and ESC 2012 guidelines (LDL 100 to 160, and >70 or >100 mg/dL, respectively). Over a median follow up of 2.87 years, 178 CV and 181 renal events occurred. At multivariable Cox analyses, CV risk linearly increased with higher LDL (hazard ratio-HR per 40 mg/dL higher LDL: 1.20, 95% confidence intervals-CI 1.03-1.39); risk doubled when considering high LDL defined according to ESC 2012 (HR 2.37, 95%CI 1.39-4.03) while this association was not significant when considering the higher threshold levels of ATPIII 2001 (HR 1.10, 95%CI 0.82-1.49). No association emerged between LDL and renal risk. Conclusion: In non-dialysis CKD patients, CV risk increases linearly with higher LDL and is more than doubled when considering the lower threshold values currently indicated for defining optimal LDL level.
|Titolo:||Prognostic role of LDL cholesterol in non-dialysis chronic kidney disease : Multicenter prospective study in Italy|
|Parole Chiave:||cardiovascular risk; cholesterol; chronic kidney disease; esrd; ldl; nephrology; renal clinic; aged; aged, 80 and over; cardiovascular diseases; cholesterol; cholesterol, ldl; female; glomerular filtration rate; humans; italy; kidney function tests; male; middle aged; prognosis; prospective studies; renal insufficiency, chronic; risk factors; severity of illness index; medicine (miscellaneous); endocrinology, diabetes and metabolism; nutrition and dietetics; cardiology and cardiovascular medicine|
|Settore Scientifico Disciplinare:||Settore MED/14 - Nefrologia|
|Data di pubblicazione:||2015|
|Digital Object Identifier (DOI):||10.1016/j.numecd.2015.04.001|
|Appare nelle tipologie:||01 - Articolo su periodico|