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HDL Cholesterol Level Is Associated with Contrast Induced Acute Kidney Injury in Chronic Kidney Disease Patients

Hoon Suk Park1, Chan Joon Kim2, Byung-Hee Hwang2

  • 1Nephrology Division, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea.

Scientific Reports
|October 25, 2016
PubMed

Insights

Higher levels of high-density lipoprotein cholesterol (HDL-C) significantly reduce the risk of contrast-induced acute kidney injury (CI-AKI) in chronic kidney disease (CKD) patients undergoing percutaneous coronary intervention (PCI). This suggests targeted HDL-C management for CI-AKI prevention.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Research

Background:

  • Chronic kidney disease (CKD) is a major risk factor for contrast-induced acute kidney injury (CI-AKI).
  • Percutaneous coronary intervention (PCI) commonly involves contrast media, increasing CI-AKI risk in CKD patients.
  • The role of high-density lipoprotein cholesterol (HDL-C) in CI-AKI development and long-term outcomes in CKD patients undergoing PCI requires further investigation.

Purpose of the Study:

  • To investigate the association between serum HDL-C levels and the incidence of CI-AKI in patients with CKD undergoing PCI.
  • To evaluate the impact of HDL-C levels on long-term mortality in this patient population.

Main Methods:

  • A prospective, multicenter registry included 1592 CKD patients undergoing PCI.
  • Patients were stratified into quartiles based on serum HDL-C levels.
  • Multivariate logistic and Cox regression analyses were used to assess CI-AKI development and long-term mortality, respectively.

Main Results:

  • A significant inverse linear trend was observed between increasing HDL-C quartiles and CI-AKI development (P for trend < 0.001).
  • The incidence of CI-AKI decreased progressively across HDL-C quartiles (19.0% in Q1 to 3.7% in Q4; P < 0.001).
  • Higher HDL-C levels (highest quartile) were associated with significantly reduced long-term mortality compared to the lowest quartile (HR 0.516, P = 0.007).

Conclusions:

  • Serum HDL-C levels are a significant independent predictor of CI-AKI in CKD patients undergoing PCI.
  • Low HDL-C levels are associated with increased risk of CI-AKI and higher long-term mortality.
  • Consideration of more intensive strategies to increase HDL-C may be beneficial for preventing CI-AKI in high-risk CKD patients undergoing PCI.

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