Relationship of serum total cholesterol and triglyceride with risk of mortality in maintenance hemodialysis patients: a multicenter prospective cohort study

Abstract

Objective

The relationship between serum total cholesterol (TC) and triglyceride (TG) levels and mortality in maintenance hemodialysis (MHD) patients remains inconsistent. We aimed to explore the individual and combined association of TC and TG levels with the risk of mortality in Chinese MHD patients.

Methods

1036 MHD patients were enrolled in this multicenter, prospective cohort study. The serum levels of total cholesterol and triglycerides were measured at baseline. The primary outcome was all-cause mortality and secondary outcome was cardiovascular disease (CVD) mortality.

Results

During a median follow-up duration of 4.4 years (IQR= 2.0–7.9 years), 549 (53.0%) patients died, and 297 (28.7%) deaths were attributed to CVD. Compared with patients with TC levels in the first three quartiles (<182.5 mg/dL), a significantly higher risk of all-cause mortality was found in participants with TC in the fourth quartile (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.17–1.76). However, a significantly lower risk of all-cause mortality was observed in participants with TG in the fourth quartile (≥193.9 mg/dL) (HR, 0.78; 95%CI: 0.63–0.98), compared with participants with TG in the first three quartiles. Similar trends were observed in CVD mortality. When analyzed jointly, patients with lower TC (<182.5 mg/dL) and higher TG (≥193.9 mg/dL) levels had the lowest risk of all-cause mortality and CVD mortality.

Conclusions: In MHD patients in southern China, higher TC levels were associated with higher risk of mortality, while higher TG levels were related to lower risk of mortality. Patients with lower TC and higher TG levels had the best survival prognosis.

Keywords:

• Serum total cholesterol
• serum triglyceride
• maintenance hemodialysis
• mortality
• cardiovascular mortality

Acknowledgements

We thank the participants, investigators, and staff for their contribution to this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Min Liang reports grants from the Clinical Research Program of Nanfang Hospital, Southern Medical University [2019CR021]; the Key Research Program of Southern Medical University [LC2019ZD005]; National Science and Technology Major Project of China [2020ZX09201017]; the National Key Technology Support Program of China [2015BAI12B00]; the High-level Matching Funds of Nanfang Hospital [2014070]; the Science and Technology Planning Project of Guangzhou [2014Y2-00098]. Fan Fan Hou reports grants from the Guangdong Provincial Clinical Research Center for Kidney Disease [2020B1111170013] and Key Technologies R&D Program of Guangdong Province [2023B1111030004]. Xin Xu reports grants from the National Key Research and Development Program of China [2021YFC2500200]. Yaya Yang reports grants from the President Foundation of Nanfang Hospital, Southern Medical University [2022H013].