The association between high-density lipoproteins and estimated glomerular filtration rate in patients without severe kidney disease

Int Urol Nephrol. 2018 Jun;50(6):1105-1112. doi: 10.1007/s11255-018-1851-8. Epub 2018 Mar 28.

Abstract

Purpose: Several studies investigated the association between the estimated glomerular filtration rate (eGFR) and the concentration of high-density lipoproteins (HDL) in patients without severely damaged kidney function. As results of those studies were inconclusive and contradictory, we wanted to investigate this association in multiple cardiovascular disease (CVD) risk patients without severe kidney disease or renal failure.

Methods: We enrolled a cohort of 187 patients with intermediate and high CVD risk without severe renal disease. We grouped them based on their eGFR into: group 1 (≥ 30 < 60 ml/min/1.73 m2), group 2 (≥ 60 < 90 ml/min/1.73 m2) and group 3 (≥ 90 ml/min/1.73 m2). We analyzed the difference between their HDL levels and assessed the association of HDL and eGFR in three regression models with the following predictors: model 1 (age and gender), model 2 (model 1 plus smoking status, hs-CRP and diabetes mellitus) and model 3 (model 2 plus excessive weight and obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, family history of CVD and medications they used).

Results: Patients with the lowest eGFR had the lowest HDL values (P = 0.013). In multiple linear regression, HDL was an independent predictor of eGFR (β = 0.189, P = 0.025) which was also shown in multinomial regression for all three models: model 1 [odds ratio (OR) 0.05; 95% confidence interval (CI) 0.007-0.331; P = 0.002], model 2 (OR 0.052; 95% CI 0.006-0.428; P = 0.006) and model 3 (OR 0.2; 95% CI 0.001-0.309; P = 0.005).

Conclusions: Low HDL is an independent predictor of lower eGFR in intermediate and high CVD risk patients without severe kidney disease. In such patients, low HDL could be one of the early indicators of renal failure.

Keywords: Glomerular filtration rate; HDL; Lipoproteins; Risk factors.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / physiopathology
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney Diseases / blood*
  • Kidney Diseases / physiopathology
  • Lipoproteins, HDL / blood*
  • Logistic Models
  • Male
  • Mean Platelet Volume
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors

Substances

  • Biomarkers
  • Blood Glucose
  • Lipoproteins, HDL