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Abstract: FR-PO280

Association of Serum Triglycerides and Mortality Across Albuminuria Stages Among US Veterans

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Soohoo, Melissa, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Hsiung, Jui-Ting, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Park, Christina, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Marroquin, Maria V., Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Moradi, Hamid, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
Background

Elevated serum triglycerides (TG) are a risk factor for mortality in the general population, however the relationship is less clear among chronic kidney disease (CKD) patients. Prior studies have evaluated the relationship of TG with mortality in CKD with estimated glomerular filtration rate (eGFR). However, data is lacking on how albuminuria, or urinary albumin-creatinine ratio (UACR), may impact the TG-mortality association.

Methods

Our cohort comprised 994,338 US veterans with a TG measurement between 2004-2006 and were followed until 2014. Albuminuria or UACR prior to TG measurement were extracted either as a calculated ratio, or via dipstick methods. We used Cox proportional hazard models with adjustments for demographics, comorbidities, body mass index and albumin levels to evaluate the association of TG with all-cause and cardiovascular (CV) mortality stratified by UACR groups.

Results

Mean (±SD) cohort age was 63±14 years old, with a median [IQR] TG of 128[87,192] mg/dL. A majority of patients had low levels of UACR <30 mg/g, whereas 2% had high levels of UACR >300 mg/g. The proportion of patients with UACR>300 mg/g increased with increasing TG. We observed a slight U-shaped association between TG and all-cause and CV mortality, among UACR <30 mg/g and UACR 30-300 mg/g stages. In particular, high TG ≥240 mg/dL were associated with the highest risk of CV mortality compared to TG 120-<160 mg/dL among those with UACR<30 mg/g [HR [95%CI]: 1.17[1.14, 1.20]]. These associations were incrementally lower for UACR 30-300 mg/g. Among UACR >300 mg/g patients, higher TG was associated with an even lower to null relationship with CV mortality. For low TG <80 mg/dL mortality risk estimates were higher for higher UACR stages, particularly for all-cause mortality.

Conclusion

We observed a U-shaped association between TG with all-cause and CV mortality among patients with UACR ≤300 mg/g, while TG-CV mortality associations for UACR>300 were weaker. Further studies are needed to evaluate how albuminuria may impact cardiovascular risk with elevated TG.

Funding

  • Veterans Affairs Support