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Cited by 103Lipoproteins and Cardiovascular HealthChronic Kidney Disease and DiabetesParaoxonase enzyme and polymorphisms

The DOI matches its Crossref record; 31 of the 32 references it cites were found in a registry or an index.

HDL Cholesterol Is Not Associated with Lower Mortality in Patients with Kidney Dysfunction

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Zewinger, Stephen, Speer, Thimoteus, Kleber, Marcus E., Scharnagl, Hubert, Woitas, Rainer, Lepper, Philipp M., Pfahler, Karolin, Seiler, Sarah, Heine, Gunnar H., März, Winfried, Silbernagel, Günther, Fliser, Danilo·2014·Journal of the American Society of Nephrology
DOI 10.1681/asn.2013050482PMC PMC4005298
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Abstract

In the general population, HDL cholesterol (HDL-C) is associated with reduced cardiovascular events. However, recent experimental data suggest that the vascular effects of HDL can be heterogeneous. We examined the association of HDL-C with all-cause and cardiovascular mortality in the Ludwigshafen Risk and Cardiovascular Health study comprising 3307 patients undergoing coronary angiography. Patients were followed for a median of 9.9 years. Estimated GFR (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration eGFR creatinine-cystatin C (eGFRcreat-cys) equation. The effect of increasing HDL-C serum levels was assessed using Cox proportional hazard models. In participants with normal kidney function (eGFR>90 ml/min per 1.73 m(2)), higher HDL-C was associated with reduced risk of all-cause and cardiovascular mortality and coronary artery disease severity (hazard ratio [HR], 0.51, 95% confidence interval [95% CI], 0.26-0.92 [P=0.03]; HR, 0.30, 95% CI, 0.13-0.73 [P=0.01]). Conversely, in patients with mild (eGFR=60-89 ml/min per 1.73 m(2)) and more advanced reduced kidney function (eGFR<60 ml/min per 1.73 m(2)), higher HDL-C did not associate with lower risk for mortality (eGFR=60-89 ml/min per 1.73 m(2): HR, 0.68, 95% CI, 0.45-1.04 [P=0.07]; HR, 0.84, 95% CI, 0.50-1.40 [P=0.50]; eGFR<60 ml/min per 1.73 m(2): HR, 1.18, 95% CI, 0.60-1.81 [P=0.88]; HR, 0.82, 95% CI, 0.40-1.69 [P=0.60]). Moreover, Cox regression analyses revealed interaction between HDL-C and eGFR in predicting all-cause and cardiovascular mortality (P=0.04 and P=0.02, respectively). We confirmed a lack of association between higher HDL-C and lower mortality in an independent cohort of patients with definite CKD (P=0.63). In summary, higher HDL-C levels did not associate with reduced mortality risk and coronary artery disease severity in patients with reduced kidney function. Indeed, abnormal HDL function might confound the outcome of HDL-targeted therapies in these patients.

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Crossref · 10.1681/asn.2013050482

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  1. Voight, 2012, Plasma HDL cholesterol and risk of myocardial infarction: A mendelian randomisation study., Lancet, 380, 572, 10.1016/S0140-6736(12)60312-2 · DOI · Paper page

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Metadata

Authors
Zewinger, S., Speer, T., Kleber, M. E., Scharnagl, H., Woitas, R., Lepper, P. M., Pfahler, K., Seiler, S., Heine, G. H., März, W., Silbernagel, G., & Fliser, D.
Affiliations
  • Heidelberg University (DE)
  • Medical University of Graz (AT)
  • University of Bonn (DE)
  • Universitätsklinikum des Saarlandes (DE)
  • University Hospital of Bern (CH)
Corresponding author
  • Zewinger, Stephen
  • Speer, Thimoteus
  • Pfahler, Karolin
  • Seiler, Sarah
  • Heine, Gunnar H.
  • Silbernagel, Günther
  • Fliser, Danilo
ORCID
Venue
Journal of the American Society of Nephrology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-05
Volume
25
Issue
5
Pages
1073-1082
ISSN
1046-6673 (ISSN-L)
DOI
10.1681/asn.2013050482
PMC
PMC4005298
OpenAlex
W2165758797
Cited by
103
References
32
Citations by year
2026: 2 · 2025: 8 · 2024: 4 · 2023: 9 · 2022: 6 · 2021: 5 · 2020: 11 · 2019: 13 · 2018: 9 · 2017: 13 · 2016: 9 · 2015: 8 · 2014: 6
FWCI
11.89
Type
journal article
Language
en
Open access
Locations
  • Journal of the American Society of Nephrology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • BORIS (University Library Bern) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Paraoxonase enzyme and polymorphisms
Keywords
HDL cholesterol, chronic kidney disease, estimated glomerular filtration rate, all-cause mortality, cardiovascular mortality, coronary artery disease severity, cardiovascular risk prediction, coronary angiography patients, cardiovascular risk stratification, cardiovascular risk reclassification
MeSH terms
Aged, Cardiovascular Diseases, Female, Follow-Up Studies, Germany, Humans, Cholesterol, HDL, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Coronary Angiography, Renal Insufficiency, Chronic, ErbB Receptors

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