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. 2023 May:111:90-96.
doi: 10.1016/j.ejim.2023.02.019. Epub 2023 Mar 10.

Hypertriglyceridemia is associated with decline of estimated glomerular filtration rate and risk of end-stage kidney disease in a real-word Italian cohort: Evidence from the TG-RENAL Study

Roberto Pontremoli  1 , Giovambattista Desideri  2 , Marcello Arca  3 , Pier Luigi Temporelli  4 , Valentina Perrone  5 , Melania Dovizio  5 , Claudio Borghi  6 , Luca Degli Esposti  5 ; on the behalf of Local Health Units Group
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Free article

Hypertriglyceridemia is associated with decline of estimated glomerular filtration rate and risk of end-stage kidney disease in a real-word Italian cohort: Evidence from the TG-RENAL Study

Roberto Pontremoli et al. Eur J Intern Med. 2023 May.
Free article

Abstract

Background: This analysis investigated the role of hypertriglyceridemia on renal function decline and development of end-stage kidney disease (ESKD) in a real-world clinical setting.

Methods: A retrospective analysis using administrative databases of 3 Italian Local Health Units was performed searching patients with at least one plasma triglyceride (TG) measurement between 2013 and June 2020, followed-up until June 2021. Outcome measures included reduction in estimated glomerular filtration rate (eGFR) ≥30% from baseline and ESKD onset. Subjects with normal (normal-TG), high (HTG) and very high TG levels (vHTG) (respectively <150 mg/dL, 150-500 mg/dL and >500 mg/dL) were comparatively evaluated.

Results: Overall 45,000 subjects (39,935 normal-TGs, 5,029 HTG and 36 vHTG) with baseline eGFR of 96.0 ± 66.4 mL/min were considered. The incidence of eGFR reduction was 27.1 and 31.1 and 35.1 per 1000 person-years, in normal-TG, HTG and vHTG subjects, respectively (P<0.01). The incidence of ESKD was 0.7 and 0.9 per 1000 person-years, in normal-TG and HTG/vHTG subjects, respectively (P<0.01). Univariate and multivariate analyses revealed that HTG subjects had a risk of eGFR reduction or ESKD occurrence (composite endpoint) increased by 48% compared to normal-TG subjects (adjusted OR:1.485, 95%CI 1.300-1.696; P<0.001). Moreover, each 50 mg/dL increase in TG levels resulted in significantly greater risk of eGFR reduction (OR:1.062, 95%CI 1.039-1.086 P<0.001) and ESKD (OR:1.174, 95%CI 1.070-1.289, P = 0.001).

Conclusions: This real-word analysis in a large cohort of individuals with low-to-moderate cardiovascular risk suggests that moderate-to-severe elevation of plasma TG levels is associated with a significantly increased risk of long-term kidney function deterioration.

Keywords: End-stage kidney disease; Hypertriglyceridemia; Real-world evidence; Triglycerides; eGFR reduction.

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Conflict of interest statement

Declaration of Competing Interest R. Pontremoli has served as a consultant for and has received lecturing fees from Novartis, MSD, AstraZeneca, Boehringer-Ingelheim, Lilly, Novonordisk and Alfasigma. G. Desideri has received research grant support from AstraZeneca and Menarini; has served as a consultant for Servier, Menarini, FIRMA, and Alfasigma; and received lecturing fees from Servier, Bayer, Guidotti, Bristol Myers Squibb, DOC, and Alfasigma M. Arca has received research grant support from Aegerion, Amgen, IONIS, Akcea Therapeutics, Pfizer, Regeneron, and Sanofi; has served as a consultant for Amgen, Aegerion, Akcea Therapeutics, Regeneron, Sanofi, and Alfasigma; and received lecturing fees from Amgen, Aegerion, Merck, Pfizer, Sanofi, and Alfasigma. P.L. Temporelli has received lecturing and consulting fees from Alfasigma; consulting fees from Bayer; lecturing fees from Menarini, MSD, and Servier. C. Borghi has received research grant support from Menarini Corporate and Novartis Pharma; has served as a consultant for Novartis Pharma, Alfasigma, Grunenthal, Menarini Corporate, and Laboratoires Servier; and received lecturing fees from Laboratoires Servier, Takeda, Astellas, Teijin, Novartis Pharma, Berlin Chemie, and Sanofi. The agreement signed by CliCon s.r.l. and Alfasigma does not create any entity, joint venture or any other similar relationship between the parties. CliCon s.r.l. is an independent company. Neither CliCon s.r.l. nor any of their representatives are employees of Alfasigma for any purpose. The remaining authors have no disclosures to report.

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