Kidney Week

Abstract: TH-PO468

Plasma Sphingolipid and Mortality Risk in Incident Hemodialysis Patients

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

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

Authors

• Fitzpatrick, Jessica, The Hospital for Sick Children, Toronto, Ontario, Canada

Jessica Fitzpatrick,

• Sozio, Stephen M., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Stephen M. Sozio,

• Jaar, Bernard G., Johns Hopkins University and Nephrology Center of Maryland, Baltimore, Maryland, United States

Bernard G. Jaar,

• Estrella, Michelle M., University of California, San Francisco and San Francisco VA Medical Center, San Francisco, California, United States

Michelle M. Estrella,

• Monroy-Trujillo, Jose Manuel, Johns Hopkins University , Baltimore, Maryland, United States

Jose Manuel Monroy-Trujillo,

• Parekh, Rulan S., The Hospital For Sick Children, Toronto, Ontario, Canada

Rulan S. Parekh,

• Mitsnefes, Mark, Cincinnati Children's Hospital, Cincinnati, Ohio, United States

Mark Mitsnefes,

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Funding

• NIDDK Support