Abstract: TH-PO1101
Association of Remnant Cholesterol Levels with the Initiation of Kidney Replacement Therapy in Patients with CKD: Results from the KNOW-CKD Study
Session Information
- CKD: Therapies, Innovations, and Insights
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Kim, Minsang, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea (the Republic of)
- Cho, Semin, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Korea (the Republic of)
- Oh, Kook-Hwan, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea (the Republic of)
Background
Although remnant cholesterol (RC) is an established risk factor for atherosclerotic cardiovascular diseases, its role in the progression of chronic kidney disease (CKD) remains unclear. Thus, we aimed to investigate the association between RC levels and adverse kidney outcomes in patients with CKD.
Methods
We analyzed data from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease, a prospective multicenter cohort study. Participants were categorized into quartiles based on their RC levels, which were calculated as total cholesterol level minus low-density lipoprotein cholesterol level minus high-density lipoprotein cholesterol level. The primary outcome was the initiation of kidney replacement therapy (KRT), including dialysis or kidney transplantation during the follow-up period.
Results
A total of 2,087 patients with CKD were enrolled. During a median follow-up of 8.0 years, 654 patients (31%) underwent KRT. Higher RC levels were significantly associated with an increased risk of KRT initiation. Compared to the lowest quartile (Q1), the adjusted hazard ratios (aHRs) for KRT initiation were 1.22 (95% CI, 0.95–1.57) for Q2, 1.32 (95% CI, 1.03–1.70) for Q3, and 1.42 (95% CI, 1.07–1.89) for Q4 (Figure). A 1-standard deviation increase in the RC level was associated with a 16% higher risk of KRT initiation (aHR, 1.16; 95% CI, 1.05–1.29). This association remained significant across various subgroups, particularly in patients with diabetes and early-stage CKD.
Conclusion
Elevated RC levels were independently associated with a higher risk of KRT initiation in patients with CKD. These findings suggest that RC may contribute to CKD progression and underscore the need for further studies to evaluate the potential benefits of RC-targeted lipid-modifying strategies in preserving kidney function.
Funding
- Clinical Revenue Support