ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: TH-PO468

Plasma Sphingolipid and Mortality Risk in Incident Hemodialysis Patients

Session Information

Category: Hypertension and CVD

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


  • 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

ESRD patients receiving hemodialysis (HD) are at high risk of mortality, particularly cardiovascular (CVD) mortality. Plasma sphingolipids have been identified as predictors of CVD mortality in the general population. Despite the high prevalence of dyslipidemia in HD, no studies have examined the associations of sphingolipids with mortality risk in this population.


This study included 368 incident HD patients enrolled in the Predictors of Arrhythmic and Cardiovascular Risk in ESRD (PACE) study. Plasma sphingolipid (ceramides, glucosylceramides and lactosylceramides) levels were measured at baseline by liquid chromatography-tandem mass spectrometry. Proportional hazards regression was used to examine the association of sphingolipids with CVD mortality and all-cause mortality.


At baseline, mean age was 55 years, 39% were female, 72% were African American, 58% had diabetes, and the mean comorbidity index was 5.2. Over a median 2.5 years (IQR: 1.4-3.5 years) of follow-up, there were 78 deaths from all causes, of which 33 were from CVD. The highest tertile of glucosylceramide C16GC (0.81-5.88 μM) was associated with increased risk of all-cause (HR: 1.81; 95%CI: 1.02-3.22) and CVD mortality (HR: 2.63, 95%CI: 1.08-6.55) as compared to the lowest tertile (0.03-0.40 μM) after adjusting for demographics and comorbidity.[Figure] There was no evidence of association between other sphingolipids and risk of all-cause or CVD mortality.


Glucosylceramide C16GC was associated with CVD and all-cause mortality among adults incident to HD. These results suggest that glycosphingolipid imbalance may contribute to increased mortality risk in ESRD. Further studies are needed to confirm these new and important findings.


  • NIDDK Support