Kidney Week

Abstract: SA-PO774

Associations of Cholesterol and Mortality Across eGFR Strata in the NHANES Cohort

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - III
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Benson-Hernandez, Taryn B., UC Irvine Medical Center, Bishop, California, United States

Taryn B. Benson-Hernandez,

• Soohoo, Melissa, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States

Melissa Soohoo,

• Moradi, Hamid, University of California, Irvine, Orange, California, United States

Hamid Moradi,

• Kleine, Carola-Ellen, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States

Carola-Ellen Kleine,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States

Kamyar Kalantar-Zadeh,

• Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States

Elani Streja,

Background

Prior studies in chronic kidney disease (CKD) patients have shown a paradoxical association where CKD patients with higher cholesterol did not have the higher risk of mortality, as observed in the general population. However, the cholesterol-mortality relationship has not been thoroughly examined in a single nationally representative cohort with the ability to assess the impact of CKD stage on this relationship.

Methods

Using data from the National Health and Nutrition Examination Surveys (NHANES), we identified 31,270 adults with available measurements on serum cholesterol and creatinine between 1999-2006. We examined the association of cholesterol with mortality in 6 groups of cholesterol, and stratified by 3 levels of estimated glomerular filtration rate (eGFR). Associations were examined with Cox models with multivariable adjustment for demographics, comorbidities, medication use, body mass index and albumin.

Results

The cohort mean age was 47±20 years and comprised of 52% females and 20% non-Hispanic black patients. Patients with higher cholesterol tended to be older, female, non-Hispanic white, but less likely to be diabetic, or take medications for high cholesterol. Over a median follow-up of 6[3, 9] years, 2,802 deaths occurred. Compared to cholesterol 175-<200 mg/dL, both low and high cholesterol was associated with higher death risk in unadjusted models, but associations for higher cholesterol was attenuated after age adjustment. In fully adjusted models, patients with lower cholesterol (<150 mg/dL) had or trended towards a higher risk of mortality across all strata of eGFR. Yet, higher cholesterol was not associated with higher mortality risk in any strata of eGFR. [Figure]

Conclusion

Among the nationally representative NHANES cohort, higher cholesterol is not associated higher mortality risk. Future studies evaluating the impact of kidney disease on the cholesterol-mortality association are needed.