Document Detail

Low-density lipoprotein cholesterol: association with mortality and hospitalization in hemodialysis patients.
MedLine Citation:
PMID:  15665509     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Hypocholesterolemia is a common finding in hospitalized elderly people, critically ill surgical patients, septic patients and end-stage renal disease patients. The different effect of lipid subfractions on patients with end-stage renal disease has never been demonstrated. We aim to study the effect of lipid subfractions on hospitalization and mortality in maintenance hemodialysis (MHD) patients. METHODS: Lipid subfractions, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured in 210 patients with MHD in a single dialysis center. Patients were stratified into three groups based on the tertiles of lipid levels, and differences in patient characteristics and survival were evaluated. RESULTS: Of a total of 22 deceased patients in our MHD cohort, infection-related mortality (50%) was higher than cardiovascular-related mortality (18.2%). Significant differences (p < 0.05) in the duration and frequency of hospitalization and in mortality events were observed when patients were divided into different subgroups according to the tertiles of baseline TC and LDL-C levels. Patients with lower LDL had significantly lower levels of albumin, TC and TG. The LDL-C tertiles were similar in terms of age, hypertension, diabetes, biochemical results, hematocrit, adequacy of hemodialysis and normalized protein catabolism rate. Both TC and LDL-C predicted survival (p < 0.001), but not TG and HDL-C in the Kaplan-Meier model. The Cox proportional hazard model demonstrated that baseline serum LDL-C was the best lipid subfraction in predicting all-cause death with an adjusted hazard ratio (95% confidence interval) for each 10 mg/dl of 0.752 (0.631-0.898; p = 0.002). CONCLUSIONS: We firstly demonstrated that lipid subfractions, including TC and LDL-C, predict poor outcomes in a MHD cohort with high infection-related mortality.
Chih-Kang Chiang; Tai-I Ho; Shih-Ping Hsu; Yu-Sen Peng; Mei-Fen Pai; Shao-Yu Yang; Kuan-Yu Hung; Tun-Jun Tsai
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-01-21
Journal Detail:
Title:  Blood purification     Volume:  23     ISSN:  0253-5068     ISO Abbreviation:  Blood Purif.     Publication Date:  2005  
Date Detail:
Created Date:  2005-03-08     Completed Date:  2005-07-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  134-40     Citation Subset:  IM    
Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Aged, 80 and over
Cardiovascular Diseases / mortality
Cause of Death
Cholesterol, LDL / blood*
Infection / mortality
Kidney Failure, Chronic / blood*,  complications,  mortality
Lipids / blood
Middle Aged
Proportional Hazards Models
Renal Dialysis
Survival Analysis
Reg. No./Substance:
0/Cholesterol, LDL; 0/Lipids

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