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Kidney Week

Abstract: PO0466

Short-Term Associations of Triglycerides with Atherosclerotic and Non-Atherosclerotic Cardiovascular Disease Hospitalizations Across CKD Stages

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

In chronic kidney disease (CKD) patients, we showed that the risk of atherosclerotic cardiovascular disease (ASCVD) and non-ASCVD events with high baseline triglycerides (TG) incrementally attenuated across worse CKD stages, where high TG was associated with lower risk of non-ASCVD events in late-stage CKD. TG levels can change with CKD progression, but associations of time-varying TG with ASCVD or non-ASCVD hospitalizations is unknown.

Methods

We examined time-varying TG with time to first ASCVD or non-ASCVD hospitalization in 2,963,176 US veterans who received care in 2004-2006 (baseline) and were followed to 2014. Events were classified by primary ICD-9 codes. Using time-varying Cox models, we evaluated associations of time-varying TG with first ASCVD or non-ASCVD events stratified by baseline CKD stage, with adjustment for demographics, and time-varying comorbidities and laboratory values.

Results

The cohort was 63±14 years old with a median[IQR]TG 127[87,189] mg/dL, and 23% had CKD 3A or higher at baseline. TG <80 mg/dL was associated with a lower risk of time to first ASCVD event (ref: TG 120-<160 mg/dL) for all baseline CKD stages (Fig A). There was a linear association between time-varying TG and ASCVD events. High TG≥240 mg/dL had the highest risks for ASCVD, for baseline non-CKD, and CKD 3A-3B. Among late-stage CKD patients, the association of high TG and ASCVD was null. We observed an inverse association between time-varying TG with time to first non-ASCVD event (Fig B). Patients with low TG had faster times to first non-ASCVD event for non-CKD and CKD 3A-4, while high TG were associated with slower times in all stages. CKD stage 5/end-stage renal disease patients with TG ≥240 mg/dL had the lowest risk of non-ASCVD event.

Conclusion

Short-term risk of higher TG with ASCVD or non-ASCVD events incrementally decreased across CKD stages, where risk was lower to null in late stage patients. High TG were associated with lower risks of non-ASCVD across all CKD stages. Investigation is needed to evaluate the pathways involving TG and cardiac events as CKD severity progresses in order to best manage health.