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. 2018 Mar 3;10(3):300.
doi: 10.3390/nu10030300.

Effects of Cholesterol Levels on Mortality in Patients with Long-Term Peritoneal Dialysis Based on Residual Renal Function

Yen-Chung Lin  1   2   3 , Yi-Chun Lin  4   5 , Chiung-Chi Peng  6 , Kuan-Chou Chen  7 , Hsi-Hsien Chen  8   9 , Te-Chao Fang  10   11 , Shian-Ying Sung  12 , Mai-Szu Wu  13   14
Affiliations

Effects of Cholesterol Levels on Mortality in Patients with Long-Term Peritoneal Dialysis Based on Residual Renal Function

Yen-Chung Lin et al. Nutrients. .

Abstract

The effect of dyslipidemia on peritoneal dialysis (PD) patients based on the presence of residual renal function (RRF; renal creatinine clearance >2 mL/min/1.73 m²) is unknown. Data from the Taiwan Renal Registry Data System between 2005 and 2012 were analyzed to estimate the association between dyslipidemia and mortality in PD patients. Long-term PD patients (n = 8032) were divided into groups with (RRF; n = 2691, 33.5%) and without RRF (non-RRF; n = 5341, 66.5%). The primary outcome was three-year mortality, and multivariate Cox regression was used for survival analysis. After stratifying the total cholesterol (TC) level between the first and third years, the hazard ratio for mortality was estimated. In the non-RRF group, TC < 120 mg/dL was associated with independently increased risk of mortality. In the RRF group, low TC was not independently correlated with increased mortality, but TC > 285 mg/dL was associated with increased risk. PD patients with higher level of TC (>200 mg/dL) in both first and third years of dialysis had significantly lower risk of mortality. In this nationwide cohort study, PD patients without RRF who had low TC level had the highest mortality, in contrast to those with RRF. Malnutrition in long-term PD patients without RRF is an important issue to be monitored.

Keywords: lipid; malnutrition; mortality; peritoneal dialysis; residual renal function.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The flow chart of the study population (n = 8032). PD: peritoneal dialysis; HD: hemodialysis; TC: total cholesterol.
Figure 2
Figure 2
The Kaplan–Meier curve showing that hypocholesterolemia (TC < 150 mg/dL) in patients without RRF (A) had the worst survival rate, but not in patients with RRF (B).
Figure 3
Figure 3
The unadjusted and adjusted hazard ratio (HR) of mortality in short interval TC levels demonstrated an U-shape curve among the patients without RRF (A) and linear curve among the patients with RRF (B).
See this image and copyright information in PMC

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