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Abstract: FR-PO415

The Target Cholesterol Level for Favorable Prognosis in Hemodialysis Patients: 10-Year Outcomes of the Q-Cohort Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Nakano, Toshiaki, Kyushu University, Fukuoka, Japan
  • Hiyamuta, Hiroto, Kyushu University, Fukuoka, Japan
  • Yotsueda, Ryusuke, Kyushu University, Graduate School of Medical Sciences, Fukuoka City, FUKUOKA, Japan
  • Tanaka, Shigeru, Kyushu University, Fukuoka, Japan
  • Taniguchi, Masatomo, Fukuoka Renal Clinic, Fukuoka, Japan
  • Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan
  • Kitazono, Takanari, Department of Medicine and Clinical Science, Fukuoka, Japan
Background

The prevalence of atherosclerotic diseases is higher in hemodialysis patients. The aim of the current study was to determine the target cholesterol level for the best prognosis in patients undergoing long-term hemodialysis.

Methods

A total of 3,517 participants undergoing maintenance hemodialysis were followed up for 10 years. The outcomes were the incidences of cardiovascular disease (CVD) and mortality. Total cholesterol (TC) in mg/dL was divided into the following quartiles derived from baseline data: Q1 < 131, Q2 ≥ 131 and < 152, Q3 ≥ 152 and < 178, and Q4 ≥ 178. To determine the cholesterol level of the best prognosis, we used a multivariable-adjusted restricted cubic spline model.

Results

During the follow-up period 1,033 patients had CVD, and 1,742 patients died. Compared with Q1, the respective multivariable-adjusted hazard ratios and associated 95% confidence intervals for ischemic heart disease (IHD), peripheral artery disease (PAD), and CVD in Q4 were 1.40 (1.05–1.85), 1.35 (0.93–1.98), and 1.28 (1.07–1.54). The incidences of IHD, PAD, and CVD were significantly positively associated with higher cholesterol levels after adjustment for confounding factors (p for trend < 0.05). Compared with Q4, the respective multivariable-adjusted hazard ratios and associated 95% confidence intervals for CVD mortality, infection-associated mortality, cancer-associated mortality, and all-cause mortality in Q1 were 1.13 (0.89–1.43), 1.09 (0.82–1.45), 1.69 (1.14–2.51), and 1.24 (1.07–1.43). The TC level at which all-cause mortality risk was lowest was 179 mg/dL.

Conclusion

Higher TC predicts IHD, PAD, and CVD events, and lower TC predicts cancer-associated mortality and all-cause mortality in patients undergoing hemodialysis. We determined the favorable value of serum cholesterol level was 179 mg/dL.