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Renal Failure Volume 46, 2024 - Issue 1
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Hemodialysis and Peritoneal Dialysis

Association of albumin to non-high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients

Yongjie Xiea Department of Nephrology, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, PR ChinaView further author information
,
Xiaoran Fengb Department of Nephrology, Jiujiang NO.1 People’s Hospital, Jiangxi, PR ChinaView further author information
,
Youqun Gaoa Department of Nephrology, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, PR ChinaView further author information
,
Xiaojiang Zhanc Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, PR ChinaView further author information
,
Fenfen Pengd Department of Nephrology, Zhujiang Hospital, Southern Medical University, Guangzhou, PR ChinaView further author information
,
Qian Zhoue Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR ChinaView further author information
,
Xianfeng Wuf Department of Nephrology, Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, PR China;g Clinical Research Center for Chronic Kidney Disease, Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, PR ChinaView further author information
,
Xiaoyang Wangh Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, PR ChinaView further author information
,
Na Tiani Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, PR ChinaView further author information
,
Qingdong Xuj Department of Nephrology, Jiangmen Central Hospital, Jiangmen, PR ChinaORCID Iconhttps://orcid.org/0000-0001-8755-7968View further author information
ORCID Icon,
Ning Suk Department of Hematology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, PR ChinaORCID Iconhttps://orcid.org/0000-0002-2799-133XView further author information
ORCID Icon,
Xingming Tangl Department of Nephropathy and Rheumatism, Dongguan Songshan Lake Tungwah Hospital, Dongguan, PR ChinaView further author information
,
Jianbo Lianga Department of Nephrology, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, PR ChinaCorrespondence[email protected]
View further author information
,
Jiao Lia Department of Nephrology, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, PR China;m Department of Cardiovascular, The Second Affiliated Hospital Guangzhou Medical University, Guangzhou, PR ChinaCorrespondence[email protected]
View further author information
&
Yueqiang Wena Department of Nephrology, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, PR ChinaCorrespondence[email protected]
View further author information
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Article: 2299601 | Received 17 Jul 2023, Accepted 21 Dec 2023, Published online: 09 Jan 2024

Figures & data

Figure 1. Flow chart-including patient enrollment and outcomes.

Figure 1. Flow chart-including patient enrollment and outcomes.

Figure 2. Restricted-cubic-spline plot of the association between albumin to non-HDL-C ratio and all-cause mortality. The median albumin to non-HDL-C ratio was 10.8.

Figure 2. Restricted-cubic-spline plot of the association between albumin to non-HDL-C ratio and all-cause mortality. The median albumin to non-HDL-C ratio was 10.8.

Table 1. Baseline characteristics of the study population.

Figure 3. The Kaplan–Meier curves with all-cause mortality by category of the level of albumin to non-HDL-C ratio. The curves were constructed using the Kaplan–Meier method and compared using the Mantel-Cox log-rank test. Patients in the highest albumin to non-HDL-C ratio group (albumin to non-HDL-C ratio > 12.79) had a lower risk of all-cause mortality. Log-rank test of lowest vs. moderate, lowest vs. highest, and moderate vs. highest, was 24.35 (p < 0.001), 36.03 (p < 0.001), and 1.124 (p = 0.288), separately.

Figure 3. The Kaplan–Meier curves with all-cause mortality by category of the level of albumin to non-HDL-C ratio. The curves were constructed using the Kaplan–Meier method and compared using the Mantel-Cox log-rank test. Patients in the highest albumin to non-HDL-C ratio group (albumin to non-HDL-C ratio > 12.79) had a lower risk of all-cause mortality. Log-rank test of lowest vs. moderate, lowest vs. highest, and moderate vs. highest, was 24.35 (p < 0.001), 36.03 (p < 0.001), and 1.124 (p = 0.288), separately.

Table 2. Albumin to non-HDL-C ratio predicts the prognosis of all-cause mortality in PD patients.

Figure 4. A: ROC curves of 3 indicators: albumin/non-HDL-C, non-HDL-C, albumin. The areas under the ROC curve (AUC) of albumin/non-HDL-C, non-HDL-C, albumin were 0.604 (p < 0.001), 0.583 (p < 0.001), and 0.552 (p < 0.001), respectively. B: ROC curves of 4 indicators: albumin/non-HDL-C, hs-CRP, BMI, and nPCR. The areas under the ROC curve (AUC) of albumin/non-HDL-C, hs-CRP, BMI, and nPCR were 0.523 (p = 0.123), 0.502 (p = 0.907), and 0.609 (p < 0.001), respectively.

Figure 4. A: ROC curves of 3 indicators: albumin/non-HDL-C, non-HDL-C, albumin. The areas under the ROC curve (AUC) of albumin/non-HDL-C, non-HDL-C, albumin were 0.604 (p < 0.001), 0.583 (p < 0.001), and 0.552 (p < 0.001), respectively. B: ROC curves of 4 indicators: albumin/non-HDL-C, hs-CRP, BMI, and nPCR. The areas under the ROC curve (AUC) of albumin/non-HDL-C, hs-CRP, BMI, and nPCR were 0.523 (p = 0.123), 0.502 (p = 0.907), and 0.609 (p < 0.001), respectively.

Figure 5. Competitive risk models. Estimated cumulative incidence curves between the all-cause mortality and other competing events for each albumin to non-HDL-C ratio group. The cumulative incidence curves for different albumin to non-HDL-C ratio groups are highly significant for the all-cause mortality (p < 0.001), while there is no statistical significance for the occurrence of other competing events (being transferred to hemodialysis therapy, being transferred to kidney transplantation, being transferred to other centers).

Figure 5. Competitive risk models. Estimated cumulative incidence curves between the all-cause mortality and other competing events for each albumin to non-HDL-C ratio group. The cumulative incidence curves for different albumin to non-HDL-C ratio groups are highly significant for the all-cause mortality (p < 0.001), while there is no statistical significance for the occurrence of other competing events (being transferred to hemodialysis therapy, being transferred to kidney transplantation, being transferred to other centers).

Figure 6. Sensitivity analyses. The whole cohort was categorized into four groups by the median values of non-HDL-C (3.25 mmol/L) and albumin (35.7 g/L). The repeated Kaplan-Meier curves showed the statistical significance of the association between the redefined groups and all-cause mortality (p < 0.001).

Figure 6. Sensitivity analyses. The whole cohort was categorized into four groups by the median values of non-HDL-C (3.25 mmol/L) and albumin (35.7 g/L). The repeated Kaplan-Meier curves showed the statistical significance of the association between the redefined groups and all-cause mortality (p < 0.001).
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Data availability statement

All data generated or analyzed during this study are included in this published article.

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