Association Between Atherogenic Index of Plasma and Clinical Outcomes in Peritoneal Dialysis Population

Abstract

Background: The atherogenic index of plasma (AIP), a prognostic indicator for cardiovascular disease, has not been fully explored in relation to clinical outcomes in patients receiving peritoneal dialysis. This study aims to elucidate the relationship between baseline AIP levels and all-cause mortality, cardiovascular mortality, and the peritonitis risk in this population. Methods: This retrospective cohort study included incident peritoneal dialysis patients in our center from 1 January 2006 through 31 December 2021. The end of the follow-up time was 31 December 2023. The participants were stratified by baseline AIP levels. Kaplan-Meier curves, Cox regression analyses, and subgroup analyses were used to evaluate associations with clinical outcomes. Results: The average age of the 2460 participants in this study was 45.9 years, and 1456 (59.2%) of them were men. Diabetic nephropathy (19.5%) was the second most common kidney disease, after primary glomerulonephritis (60.8%). The higher AIP tertile group was significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and peritonitis compared to the lowest AIP group, as evidenced by the Kaplan-Meier curves and the multivariate analyses. Continuous AIP levels also showed a positive correlation with the all-cause mortality and peritonitis risk, even after controlling for covariates. Conclusions: Our study highlights AIP as a predictive marker for adverse outcomes in PD patients, emphasizing its potential utility in risk stratification and clinical management.

Keywords: all-cause mortality; atherogenic index of plasma; cardiovascular mortality; clinical outcomes; peritoneal dialysis; peritonitis.

Figure 1

A flowchart of the study population. Abbreviations: PD, peritoneal dialysis; HD, hemodialysis; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; CVD, cardiovascular diseases.

Figure 2

Kaplan–Meier curves for patients with different levels of AIP: all-cause mortality (A), cardiovascular mortality (B), and peritonitis (C).

Figure 3

Subgroup analyses. A comparison of the adjusted hazard ratios of all-cause mortality, cardiovascular mortality, and peritonitis for the subgroups was presented by forest plot. Adjusted for age, gender, body mass index, history of diabetes mellitus, history of cardiovascular disease, serum albumin, uric acid, calcium, low-density lipoprotein cholesterol, blood urea nitrogen, intact parathyroid hormone, glucose, hemoglobin, and lipid-lowering drugs.