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Background <p>The use of lipid-lowering drugs in the dialysis population has been controversial and there is no target for the dialysis population.</p> Objectives <p>To elucidate the dose-response relationship between lipids and all-cause mortality in the dialysis population.</p> Methods <p>Computer searches of PubMed, Embase, Web of Science, CNKI, and Wanfang. Data were conducted to collect published cohort studies on lipids and all-cause mortality in the dialysis population from home and abroad up to February 2023. Meta-analysis was applied to calculate the combined effect size (Hazard ratio) and its 95% confidence interval and dose-response relationship by applying Stata17.0.</p> Results <p>A total of 11 publications with a cumulative total of 106,808 individuals were included. All-cause mortality was statistically different between the highest dose total cholesterol (TC) group and the low TC group (HR = 0.82, 95% CI = 0.75–0.90, <i>P</i> &lt; 0.05). The TC range for lower all-cause mortality is &gt; 140.5&#xa0;mg/dL, and on this basis, TC in the range of 180–220&#xa0;mg/dL may have a better prognosis for dialysis population. There was a nonlinear relationship between Non-high-density lipoprotein cholesterol (NHDL-C) cholesterol and all-cause mortality, with no statistical difference between the high and low dose group. In contrast, Low-density lipoprotein cholesterol (LDL-C) masked its association with all-cause mortality due to changes in death spectrum, differences in relative time risks, and other factors. In the 50–450&#xa0;mg/dL range, all-cause mortality in the dialysis population was positively associated with triglycerides (TG), with a 2.5% increase in all-cause mortality per 50&#xa0;mg/dL increase in TG (HR = 1.025, 95% CI = 1.003–1.048, <i>P</i> = 0.01).</p> Conclusion <p>TC is a target for monitoring the dialysis population, which has the lowest all-cause mortality in the range of 180–220&#xa0;mg/dL. However, NHDL-C and LDL-C monitoring is not clinically meaningful. Increased TG can contribute to the risk of higher all-cause mortality in dialysis patients.</p>

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Dose-response relationship between lipids and all-cause mortality in the dialysis population: a meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月4日

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  • Ye Yao,
  • Jing Xiong,
  • Mi-Yuan Wang

摘要

Background

The use of lipid-lowering drugs in the dialysis population has been controversial and there is no target for the dialysis population.

Objectives

To elucidate the dose-response relationship between lipids and all-cause mortality in the dialysis population.

Methods

Computer searches of PubMed, Embase, Web of Science, CNKI, and Wanfang. Data were conducted to collect published cohort studies on lipids and all-cause mortality in the dialysis population from home and abroad up to February 2023. Meta-analysis was applied to calculate the combined effect size (Hazard ratio) and its 95% confidence interval and dose-response relationship by applying Stata17.0.

Results

A total of 11 publications with a cumulative total of 106,808 individuals were included. All-cause mortality was statistically different between the highest dose total cholesterol (TC) group and the low TC group (HR = 0.82, 95% CI = 0.75–0.90, P < 0.05). The TC range for lower all-cause mortality is > 140.5 mg/dL, and on this basis, TC in the range of 180–220 mg/dL may have a better prognosis for dialysis population. There was a nonlinear relationship between Non-high-density lipoprotein cholesterol (NHDL-C) cholesterol and all-cause mortality, with no statistical difference between the high and low dose group. In contrast, Low-density lipoprotein cholesterol (LDL-C) masked its association with all-cause mortality due to changes in death spectrum, differences in relative time risks, and other factors. In the 50–450 mg/dL range, all-cause mortality in the dialysis population was positively associated with triglycerides (TG), with a 2.5% increase in all-cause mortality per 50 mg/dL increase in TG (HR = 1.025, 95% CI = 1.003–1.048, P = 0.01).

Conclusion

TC is a target for monitoring the dialysis population, which has the lowest all-cause mortality in the range of 180–220 mg/dL. However, NHDL-C and LDL-C monitoring is not clinically meaningful. Increased TG can contribute to the risk of higher all-cause mortality in dialysis patients.