Analysis of the association between residual cholesterol and all-cause mortality and cardiovascular disease mortality in maintenance hemodialysis patients
Wu Yan
Yang Fan
Yang Tingting
Shao Yunxia
Zhang Wei
Jiang Jiaojiao
Ding Yahong
Liu Chunhong
Abstract：Objective To investigate the association between residual cholesterol(RC)and all-cause mortality and cardiovascular disease mortality in maintenance hemodialysis(MHD)patients,providing references for clinical decision-making.Methods A total of 102 MHD patients receiving regular hemodialysis at a blood purification center in Wuhu Second People's Hospital from June 2018 to June 2019 were enrolled.All-cause and cardiovascular disease mortality data were collected during follow-up.The Kaplan-Meier curve was adopted to assess the impact of RC levels on all-cause mortality and cardiovascular disease mortality,which was analyzed by the Log-rank test.Cox regression was used to identify independent mortality risk factors.Results Pa-tients were assigned to low-RC and high-RC groups.Significant differences was noted in body mass index,dialysis vintage,hy-pertension comorbidity,lipid-lowering medication use,and levels of triglycerides(TG),total cholesterol(TC),sodium(Na),alkaline phosphatase(ALP),calcium(Ca),phosphorus(P),and blood urea nitrogen(BUN)(P<0.05).During a maximum 50-month follow-up,18 cases of all-cause mortality(17.6%)and 15 cases of cardiovascular disease mortality(14.7%)oc-curred.Cumulative cardiovascular survival rates were 73.3%in the high-RC group and 94.7%in the low-RC group;all-cause survival rates were 71.1%in the high-RC group and 91.2%in the low-RC group.Log-rank test showed significant differences in cardiovascular disease mortality(χ2=9.853,P=0.002)and all-cause mortality(χ2=7.742,P=0.005).Cox regression indicated elevated RC was an independent risk factor for cardiovascular disease mortality(HR=2.700,95%CI:1.440-5.063,P=0.002)and all-cause mortality(HR=1.192,95%CI:1.052-1.369,P=0.009).Elevated TC was also an inde-pendent risk factor for all-cause mortality(HR=2.811,95%CI:1.381-5.731,P=0.005).Conclusion Increased RC lev-els significantly elevate cardiovascular disease mortality and all-cause mortality risks in MHD patients.Furthermore,RC level demonstrates high predictive value for cardiovascular disease and all-cause mortality and may serve as a prognostic indicator.
Keywords：Residual cholesterolMaintenance hemodialysisAll-cause mortalityCardiovascular disease mortality
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 114-120 )