Abstract: SA-PO382
Monocyte-to-High-Density Lipoprotein (HDL) Ratio, an Independent Risk Factor of Survival in Hemodialysis Patients: Results From the International MONDO Consortium
Session Information
- Hemodialysis and Frequent Dialysis: CV and Risk Prediction
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Ye, Xiaoling, Renal Research Institute, New York, New York, United States
- Bright, Rupert Benjamin Graham, Imperial College Renal and Transplant Centre, London, United Kingdom
- Woollard, Kevin, Imperial College Renal and Transplant Centre, London, United Kingdom
- Pusey, Charles D., Imperial College Renal and Transplant Centre, London, United Kingdom
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
- Duncan, Neill D., Imperial College Renal and Transplant Centre, London, United Kingdom
Group or Team Name
- The MONDO Initiative
Background
Previous studies had demonstrated that elevated monocyte count to high-density lipoprotein cholesterol ratio (MHR), a novel marker of inflammation, was associated with higher mortality in patients with CKD, on peritoneal dialysis, and deceased donor kidney transplant recipients. However, the association between MHR and mortality in patients undergoing hemodialysis (HD) has received little attention. We aimed to study the relationship between MHR and mortality in a diverse HD population.
Methods
Four cohorts were identified:1) acute phase: first 90 days on HD as the baseline period with the subsequent 9 months as the follow-up, 2) early-stable phase: 91 days to the end of 1st year as the baseline followed with 1 year’s follow-up, 3) mid-stable phase: 2nd year as the baseline and the following 1 year as the follow-up, and 4) late-stable phase: 3rd year as the baseline followed by a 7-year follow-up. All-cause & CVD mortalities were recorded during the 4 phases. Kaplan-Meier curves were constructed to explore the association between MHR quartiles and mortalities.
Results
21,059 patients were included in the acute phase cohort, 19,776 in the early-stable phase cohort, 16,680 patients in the mid-stable cohort, and 13,893 patients in the late-stable phase cohort. Notably, patients in the higher baseline MHR quartile had higher levels of NLR, MLR, CRP, platelets, and ferritin and lower albumin and phosphate in all phases. All-cause (Fig. 1) and CVD mortalities were higher in patients in higher MLR quartiles in all cohorts.
Conclusion
A higher MHR was an independent risk factor for all-cause and CV mortality in this large and ethnically diverse HD population. MHR may be a reliable biomarker due to the connection between HDL and monocytes. This work corroborates previous findings in more restricted cohorts and warrants further mechanistic investigation.