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Abstract: TH-PO161

Dyslipidemia and Outcomes in NEPTUNE

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders


  • Sethna, Christine B., Cohen Children's Medical Center of NY, New Hyde Park, New York, United States
  • Meyers, Kevin E.C., The Children Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Brady, Tammy M., Johns Hopkins University , Baltimore, Maryland, United States
  • Gadegbeku, Crystal A., Temple University, Philadelphia, Pennsylvania, United States
  • Srivastava, Tarak, Childrens's Mercy Hospital, Kansas City, Missouri, United States
  • Gibson, Keisha L., University of North Carolina Kidney Center, Chapel Hill, North Carolina, United States
  • Kretzler, Matthias, U.Michigan, Ann Arbor, Michigan, United States
  • Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States

Group or Team Name

  • NEPTUNE Cardiovascular Working Group

Patients with nephrotic syndrome (NS) have a pronounced alteration in lipoprotein metabolism. Dyslipidemia is a major risk factor for cardiovascular disease and may be associated with progression of renal disease; however, this has not been well characterized in NS.


Baseline lipid studies from the Nephrotic Syndrome Study Network (NEPTUNE) were collected. Dyslipidemia was defined as total cholesterol ≥200 mg/dL, HDL <40 mg/dL, LDL ≥130 mg/dL or triglycerides ≥100 mg/dL (0-9 yr), ≥130 mg/dL (10-17 yr), ≥50 mg/dL (≥18 yr). Cox regression adjusted for age, sex, race, disease, disease duration, baseline eGFR and urine protein:creatinine [UPC] examined the association of lipids (per 10 unit increase) with the Composite Outcome (End Stage Renal Disease or eGFR decline by ≥40%) and first Complete Remission (UPC <0.3).


271 adults (45.4±16.1 yr, 62% M) and 123 children (10.2±4.8 yr, 59% M) were evaluated. At baseline, 85% of participants had dyslipidemia (table). In the overall group, lower HDL and greater triglycerides were associated with increased hazard of the composite outcome (HR 0.91, 95%CI 0.83-0.98, p=0.02 and HR 1.02, 95%CI 1.001-1.03, p=0.001, respectively). Greater HDL (HR 1.05, 95%CI 1.001-1.1, p=0.045) was associated with increased hazard of Complete Remission. Similar relationships were found in adults for Composite Outcome (HDL: HR 0.88, 95%CI 0.79-0.98, p=0.03; triglycerides: HR 1.01, 95%CI 1.001-1.03, p=0.04) and Complete Remission (HDL: HR 1.1, 95%CI 1.03-1.18, p=0.006). In children, greater triglycerides (HR 1.05, 95%CI 1.02-1.08, p=0.001) were associated with increased hazard of the Composite Endpoint. Lipids were not associated with Complete Remission.


In NEPTUNE, dyslipidemia is common and is an independent predictor of renal outcomes.


  • NIDDK Support