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Abstract: PO0429

Risk of Pneumonia Hospitalization Associated with Serum Triglycerides Across CKD Stages in US Veterans

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Soohoo, Melissa, VA Long Beach Healthcare System, Long Beach, California, United States
  • Hsiung, Jui-Ting, VA Long Beach Healthcare System, Long Beach, California, United States
  • Kovesdy, Csaba P., Memphis VA Medical Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Streja, Elani, VA Long Beach Healthcare System, Long Beach, California, United States
Background

Small studies have suggested that chronic kidney disease (CKD) is an independent risk factor for pneumonia hospitalization. Although lipid modulating therapies are known for atherosclerotic cardiovascular disease risk reduction, they have been shown to also lower risk of pneumonia. Cholesterols were recently identified as having important roles in lung physiology and maintenance, yet the relationship of another lipid, serum triglycerides (TG) with pneumonia across CKD stages is relatively unknown.

Methods

Our cohort comprised 2,963,176 US veterans who received care from 2004-2006 (baseline) and were followed until 2014. Primary diagnosis ICD-9 codes identified inpatient pneumonia events. Using Cox proportional hazards models, we evaluated the association between baseline TG and time to first pneumonia hospitalization, stratified by CKD stage at the time of the TG measurement. Models were adjusted for demographics, comorbidities, use of lipid modulating therapies, and other biomarkers including serum lipids.

Results

Our patient cohort was on average 63±14 years old, had a median [IQR] TG of 127[87, 189] mg/dL and 23% had CKD at baseline. After full adjustment, TG <160 mg/dL were generally associated with a lower time to first pneumonia event (ref: TG 120-<160 mg/dL) for all CKD stages (Figure). Conversely, high TG ≥240 mg/dL were associated with higher risk of a pneumonia hospitalization in non-CKD and CKD stage 3A-3B patients. Notably, elevated TG >200 mg/dL were not associated with a higher risk of pneumonia among CKD stage 4, 5 and end-stage renal disease patients.

Conclusion

We observed that elevated TG were associated with higher risk of pneumonia hospitalization in non-CKD and CKD stage 3A-3B patients, but this relationship was not observed in late-stage CKD patients. While use of statins and cholesterol levels have been studied in the context of pneumonia and lung function, future studies are warranted to also investigate the role of triglycerides in pneumonia risk especially among early stage CKD patients.