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Abstract: PO2036

Association of Low-Density Lipoprotein Cholesterol with Urine Albumin-to-Creatinine Ratio Slope Across Baseline Albuminuria Strata

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Hsiung, Jui-Ting, VA Long Beach Healthcare System, Long Beach, California, United States
  • Marroquin, Maria V., VA Long Beach Healthcare System, Long Beach, California, United States
  • Soohoo, Melissa, 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

Change in urine albumin to creatinine ratio (UACR) is considered as a marker of kidney disease progression. Prior studies showed abnormal lipid levels may predict the progression of renal function decline; however, associations of low-density lipoprotein cholesterol (LDL) with UACR change is unclear. Therefore, we sought to investigate the association of LDL and UACR slope across albuminuria stages.

Methods

We analyzed 175,392 US veterans who received care between 2004 and 2006, with available serum LDL and albuminuria (UACR) data. All UACR measurements until the end of follow-up (2014) were used to ascertain UACR slopes using mixed effects modeling. The relationships between LDL with faster UACR slope (≥10 mg/g/year) stratified by baseline albuminuria stage (A1-A3) were estimated using logistic models adjusted for baseline demographics, comorbidities, prescription of statins and non-statins, BMI, albumin, HDL, triglycerides, eGFR, and UACR.

Results

Cohort mean age was 65±11 and included 3% females, 14% African-Americans,and 87% diabetics. The median [IQR] of serum LDL level and eGFR were 97 [75,119] mg/dL and 73 [58,88] mL/min/1.73m2, respectively. There was a U-shaped association between LDL and odds of faster UACR slope among A1 patients. A similar yet attenuated relationship was observed among A2 patients. Odds of faster UACR slope was higher only in patients with LDL ≥160 mg/dL and with index UACR≤300 mg/g. For A3 patients, there was no association between LDL level and UACR slope.

Conclusion

Among patients with baseline UACR <300 mg/g, both low and very high LDL were associated with higher odds of having fast UACR change. Yet, among those with higher albuminuria, the relationship with LDL and UACR change was null. More studies are needed to delve into the mechanism between LDL and CKD progression in order to further manage patients kidney health.

Funding

  • Veterans Affairs Support