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Risk factors

HDL-cholesterol levels and mortality in patients with ESRD

Nature Reviews Nephrology volume 10, pages 621–623 (2014)Cite this article

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In the general population, risk of cardiovascular disease is inversely associated with HDL-cholesterol levels. However, a new post hoc analysis of data from the German Diabetes Dialysis study reports no correlation between HDL cholesterol and mortality among patients on dialysis—a phenomenon that the authors attribute to HDL dysfunction.

High levels of serum HDL cholesterol are generally thought to protect against cardiovascular disease. However, a recent post hoc analysis of data from 1,255 diabetic patients with end-stage renal disease (ESRD) found no significant difference in cardiovascular or overall mortality between subgroups categorized according to HDL-cholesterol levels.1 Silbernagel et al. attributed the lack of salutary effects of high HDL-cholesterol levels in this study to ESRD-associated HDL dysfunction. Given the proinflammatory nature of uraemic HDL, and its impaired capacity to participate in reverse cholesterol transport, the finding that high levels of dysfunctional HDL do not confer benefit in patients with ESRD is not surprising.

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Figure 1: Effects of chronic kidney disease on HDL structure and function.

References

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  1. Division of Nephrology and Hypertension, UC Irvine Medical Center, The City Tower, 4th Floor, Orange, 92868, CA, USA

    Nosratola D. Vaziri

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  1. Nosratola D. Vaziri
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Correspondence to Nosratola D. Vaziri.

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Vaziri, N. HDL-cholesterol levels and mortality in patients with ESRD. Nat Rev Nephrol 10, 621–623 (2014). https://doi.org/10.1038/nrneph.2014.169

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