ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: SA-PO366

Combined Impact of Mean and Variability of Non-HDL-Cholesterol on Cardiovascular Risk in Patients Undergoing Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Lee, Hanbi, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
  • Yang, Chul Woo, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
  • Chung, Byung ha, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)

Non-HDL-cholesterol (non-HDL-C) is considered as a predictor of cardiovascular risk and outcomes in general population. However, dialysis patients show inconsistent association between serum cholesterol and mortality due to the presence of protein energy wasting and inflammation. Recently, a high visit-to-visit variability in cholesterol suggested to lead to the fluctuations in the composition of atherosclerotic plaques and link to cardiovascular events. This study is aimed to stratifying cardiovascular risk with the mean and variability of non-HDL-C in patients undergoing hemodialysis.


A total of 457 hemodialysis patients who had no history of myocardial infarction (MI) or stroke and who underwent ≥5 lipid profile at the seven university hospitals in South Korea between Mar 2009 and Dec 2019 were included. Sex-specific quartiles of non-HDL-C mean were used. Visit-to-visit non-HDL-C variability was calculated using the coefficient of variation, variability independent of the mean and average real variability. The low mean and high variability groups were defined as the lowest and highest quartiles of non-HDL-C mean and variability, respectively. The endpoints of the study were newly diagnosed MI, stroke, or all-cause death.


The incidence of MI was significantly higher in the low mean/high variability group than in other 3 groups. In addition, multivariable cox regression analysis demonstrated that age (hazard ratio (HR) 1.053, 95% confidence interval (CI) 1.024-1.082) and low mean/high variability group were independent risk factor for MI (HR 3.311, 95% CI 1.380-7.944). When the subjects were divided into quartile groups, neither mean nor variability of non-HDL-C was associated with MI, stroke, and all-cause mortality.


Our results suggested that the combination of low mean and high variability of non-HDL-C is associated with an increased risk of MI in hemodialysis patients, while the mean and variability per se could not stratify cardiovascular risk.