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Abstract: TH-PO469

Plasma Sphingolipids and Cardiovascular Disease Risk in Incident Hemodialysis Patients

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Fitzpatrick, Jessica, The Hospital for Sick Children, Toronto, Ontario, Canada
  • Sozio, Stephen M., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Jaar, Bernard G., Johns Hopkins University and Nephrology Center of Maryland, Baltimore, Maryland, United States
  • Estrella, Michelle M., University of California, San Francisco and San Francisco VA Medical Center, San Francisco, California, United States
  • Monroy-Trujillo, Jose Manuel, Johns Hopkins University, Baltimore, Maryland, United States
  • Parekh, Rulan S., The Hospital For Sick Children, Toronto, Ontario, Canada
  • Mitsnefes, Mark, Cincinnati Children's Hospital, Cincinnati, Ohio, United States
Background

Risk of cardiovascular (CVD) morbidity is high in adults with ESRD undergoing hemodialysis (HD). Many CVD risk factors are prevalent in ESRD, including dyslipidemia. Recent studies identified plasma sphingolipids as independent predictors of CVD in the general population; however, no studies have examined this association in HD patients.

Methods

This study included 368 incident HD patients enrolled in the Predictors of Arrhythmic and Cardiovascular Risk in ESRD (PACE) study. At baseline, plasma sphingolipid (ceramides, glucosylceramides and lactosylceramides) levels were measured by liquid chromatography-tandem mass spectrometry. We examined the cross-sectional association of sphingolipids with intermediate CVD outcomes (uncontrolled hypertension [SBP ≥140 mm Hg or DBP ≥90 mm Hg], left ventricular hypertrophy [left ventricular mass index >51 g/m2.7], and low ejection fraction [ejection fraction <55%]) using multiple logistic regression.

Results

At baseline, mean age was 55 years, 39% were female, 72% were African American, 58% had diabetes, 36% had coronary artery disease, and 41% had congestive heart failure. Higher glucosylceramide C16GC was consistently associated with higher odds of uncontrolled hypertension, left ventricular hypertrophy, and low ejection fraction independent of demographic, CVD, and dialysis factors.[Table] No other sphingolipid was consistently associated with these intermediate CVD outcomes.

Conclusion

Glucosylceramide C16GC was consistently associated with intermediate CVD outcomes. These results suggest that abnormal glycosphingolipid metabolism may contribute to increased CVD risk in ESRD. Additional studies in other dialysis cohorts are needed to confirm our results.

Funding

  • NIDDK Support