| Hyperlipidemia and long-term outcomes in nondiabetic chronic kidney disease. | |
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MedLine Citation:
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PMID: 20558558 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Dyslipidemia confers a paradoxical survival advantage in patients with kidney failure. Data are limited in the earlier stages of chronic kidney disease (CKD). DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: This was a cohort study in 840 subjects with stage 3 to 4 CKD enrolled in the Modification of Diet in Renal Disease study. Cox models were used to examine the relationship of total cholesterol (TC), non-HDL-cholesterol (NHDL-C), triglycerides (TG), and HDL-cholesterol (HDL-C) with all-cause and cardiovascular disease (CVD) mortality and progression to kidney failure. RESULTS: During a mean follow-up of 10 years, there were 208 deaths, 128 deaths from CVD, and 554 subjects reached kidney failure. There was no association between tertiles of any of the lipid variables and mortality; the lowest HDL-C tertile (1.44, 1.18 to 1.78) had increased risk of kidney failure but covariate adjustment abolished this association. In analyses with lipids as continuous variables, there was a significant association with all-cause mortality for TC (hazard ratio [HR] per 10-mg/dl increase, 95% confidence intervals [CI] = 1.03, 1.0 to 1.06) that disappeared with covariate adjustment; there was no association of TG, HDL-C, and NHDL-C as continuous variables with all-cause or CVD mortality. There was a significant inverse association between HDL-C and kidney failure (HR = 0.93, CI = 0.87 to 0.99) in an unadjusted Cox model that was attenuated after adjustment for covariates (HR = 0.98 CI = 0.91 to 1.06). CONCLUSIONS: In this cohort, with predominantly nondiabetic CKD patients, hyperlipidemia is not an independent predictor of long-term outcomes. |
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Authors:
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Varun Chawla; Tom Greene; Gerald J Beck; John W Kusek; Allan J Collins; Mark J Sarnak; Vandana Menon |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-06-17 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 5 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-08 Completed Date: 2011-01-11 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1582-7 Citation Subset: IM |
Affiliation:
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Division of Nephrology, Tufts Medical Center, Boston, MA 02111, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Chi-Square Distribution Cholesterol / blood Cholesterol, HDL / blood Female Humans Hyperlipidemias / blood, epidemiology*, mortality Kidney Diseases / epidemiology*, mortality Lipids / blood Male Middle Aged Prognosis Proportional Hazards Models Randomized Controlled Trials as Topic Risk Assessment Risk Factors Time Factors Triglycerides / blood United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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K23 DK02904/DK/NIDDK NIH HHS; K23 DK067303/DK/NIDDK NIH HHS; K24 DK078204/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Cholesterol, HDL; 0/Lipids; 0/Triglycerides; 57-88-5/Cholesterol |
| Comments/Corrections | |
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