Abstract: TH-PO468

Plasma Phospholipid Remodeling Associates with Stroke in CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Jadoon, Adil, University of Michigan, Ann Arbor, Michigan, United States
  • Rajendiran, Thekkelnaycke, Univeraity of MIchigan, Ann Arbor, Michigan, United States
  • Byun, Jaeman, University of Michigan, Ann Arbor, Michigan, United States
  • Soni, Tanu, University of Michigan, Ann Arbor, Michigan, United States
  • Pennathur, Subramaniam, University of Michigan, Ann Arbor, Michigan, United States
  • Afshinnia, Farsad, University of Michigan, Ann Arbor, Michigan, United States
Background

Stroke is a prevalent co-morbidity in chronic kidney disease (CKD). Systematic identification and quantification of complex lipids in stroke are lacking. This study is aimed at comparison of 17 different lipid classes in patient with and without a history of stroke.

Methods

This is a cross-sectional study of CKD patients from Clinical Phenotyping Resource and Biobank Core. Inclusion criteria were age greater than 18 years from all stages of CKD, frequency matched by gender and race among the CKD stages. Baseline demographic and clinical characteristics at the time of enrolment were background variables. Predictors were plasma lipid features identified by an untargeted liquid chromatography/mass spectrometry-based lipidomics platform from plasma samples obtained at the time of enrolment. Outcome was history of stroke. Lipids were internal standard normalized, log2 transformed, underwent calculation of percentage contribution to the corresponding lipid class, logit transformed, and z-score standardized for the downstream analyses.

Results

Overall 214 patients were included consisting of 184 patients without and 30 patients with stroke. Mean age was 60 years (SD=16). There were 104 females (48.6%); 64 patients (29.9%) were African-American and 150 (70.1%) were Caucasians. Distribution of body mass index, blood pressure, serum albumin, total cholesterol, lipoprotein, total triglycerides, and urine albumin-creatinine ratio was not different in patients with and without stroke. Overall we identified 330 lipid features of which 106 (32.1%) consisted of phospholipids including Phosphatidylcholines (PC, n=50), Phosphatidylethanolamine (PEs, n=28), Plasmenyl-Phosphatidylcholine (pPCs, n=6), and Plasmenyl-phosphatidylethanolamine (pPEs, n=12). Using a t-test, 36 lipids passed the nominal threshold of p<0.05 comparing patients with and without stroke, of which 23 lipids belonged to one of the phospholipid classes (over representation enrichment p=0.00004). Accordingly, PC-38:4 was the top ranking lipid with 0.73 SD higher level (95% confidence interval: 0.35 to 1.10) in stroke as compared to no stroke.

Conclusion

These findings reveal sustained significant alterations and remodeling in major plasma phospholipid subclasses in stroke in CKD patients. Further research is required to elucidate causality or long term prognostication.