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Researchers used survival models to investigate the association between HDL cholesterol and the risk of incident chronic kidney disease (CKD) and CKD progression, based on a cohort of 1,943,682 male US veterans. Progression of CKD was defined as doubling of serum creatinine, estimated glomerular filtration rate (eGFR) decline of ?30%, or a composite outcome of end-stage renal disease, dialysis, or renal transplantation. The models were adjusted for demographics, comorbid conditions, eGFR, body mass index, lipid parameters, and statin use over a median follow-up of 9 years. Compared with individuals with an HDL concentration of ?40 mg/dl, those with low HDL-C, defined as <30 mg/dl, had a 20% higher risk of incident CKD (odds ratio 1.20, 95% CI 1.18-1.22), and were also at higher risk of CKD progression, as defined by doubling of serum creatinine (odds ratio 1.14, 95% CI 1.12-1.15) GFR decline of ?30% (odds ratio 1.13, 95% CI 1.12-1.14), and the composite renal end point (odds ratio 1.08, 95% CI 1.06-1.11). In summary, the analysis showed that low HDL cholesterol was associated with increased risk of incident CKD and CKD progression, suggesting the need for its incorporation within risk factor screening panel.
1. Morton J, Zoungas S, Li Q et al. Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy. Diabetes Care 2012;35:2201–6.