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Abstract: FR-PO559

Intra-Individual Variability in High Density Lipoprotein Cholesterol and Risk of ESRD: A Nationwide Population-Based Study

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Koh, Eun Sil, The Catholic University of Korea College of Medicine, Seoul, Korea (the Republic of)
  • Shin, Seok Joon, The Catholic University of Korea College of Medicine, Seoul, Korea (the Republic of)
  • Park, Cheol Whee, The Catholic University of Korea College of Medicine, Seoul, Korea (the Republic of)
  • Chung, Sungjin, The Catholic University of Korea College of Medicine, Seoul, Korea (the Republic of)
Background

Recent studies demonstrated an association between low high density lipoprotein – cholesterol (HDL-C) and progression of chronic kidney disease (CKD). However, some of the results showed the inconsistencies between HDL-C and renal function outcomes. We investigated the association between HDL-C variability and the risk of end-stage renal disease (ESRD).

Methods

Using nationally representative data from the Korean National Health Insurance System, 3 718 355 subjects who were free of ESRD and who underwent ≥3 health examinations during 2005 to 2010 were followed to the end of 2015. HDL-C variability was measured using the coefficient of variation (CV), standard deviation (SD) and the variability independent of the mean (VIM). The primary outcome was the development of ESRD, defined as a combination of the relevant disease code and the initiation of renal replacement therapy.

Results

There were 2095 cases of ESRD during a median follow up of 4.8 years. There was a graded association between a higher HDL-C variability and incident ESRD. In the multivariable adjusted model, the hazard ratios and 95% confidence intervals comparing the highest versus lowest quartiles of VIM of HDL-C were 1.60 (95% confidence interval, 1.39–1.84). The results were consistent when the variability of HDL-C was modeled using SD and CV and were independent of preexisting CKD.

Conclusion

Increasing HDL-C variability was associated with an increasing incidence of ESRD. This findings suggest that HDL-C variability is an important risk factor of CKD progression in the general population.