Abstract: SA-PO834

Initiation of Hemodialysis Is Associated with Altered Protein Composition of High-Density Lipoprotein

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Wang, Ke, University of Washington, Seattle, Washington, United States
  • Robinson-Cohen, Cassianne, University of Washington, Seattle, Washington, United States
  • Hoofnagle, Andrew N., University of Washington, Seattle, Washington, United States
  • Kestenbaum, Bryan R., University of Washington, Seattle, Washington, United States
  • Study Group, The HFM, NIDDK, Bethesda, Maryland, United States
Background

High-density lipoprotein cholesterol (HDL-C) is composed of lipids and proteins that play important roles in cardiovascular disease development. The protein composition of HDL-C is altered in chronic dialysis patients compared to healthy controls. However, such differences conflate potential effects of kidney disease with those of dialysis procedures. We compared HDL-C associated proteins in patients recently initiating hemodialysis to those of patients with advanced chronic kidney disease (CKD).

Methods

We used liquid chromatography-mass spectrometry to quantify 38 HDL-C proteins in participants from the Hemodialysis Fistula Maturation (HFM) Study. We used linear regression to compare differences in log-transformed HDL-C proteins between 110 CKD patients awaiting dialysis (mean estimated GFR 12.8 ml/min/1.73m2) to 143 patients who initiated dialysis within the previous year. We used a q-value false discovery rate threshold of ≤0.1 to select candidate proteins that differed by dialysis status. We adjusted for age, race, gender, diabetes, body mass, smoking, prior cardiovascular disease, and statin use.

Results

Eight HDL-C associated proteins met the specified false discovery rate threshold for statistical significance (Figure). After covariate adjustment, seven of these proteins remained statistically significant at the p<0.05 level with minimal changes in effect sizes.

Conclusion

HDL-C associated proteins in pathways of inflammation and thrombosis are higher among recently initiated hemodialysis patients compared to those with late stage CKD. These findings suggest that the hemodialysis procedure itself may provoke adverse metabolic changes.

Differences in HDL-C proteins by dialysis status.

Funding

  • NIDDK Support