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High-density lipoprotein cholesterol concentration and acute kidney injury after noncardiac surgery

Yan Zhou1, Hong-Yun Yang2, Hui-Li Zhang3

  • 1Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, China. anesth.zhouyan9@gmail.com.

BMC Nephrology
|April 27, 2020
PubMed

Insights

Low High-density Lipoprotein Cholesterol (HDL) levels are an independent risk factor for postoperative acute kidney injury (AKI) after non-cardiac surgery. This finding highlights the importance of monitoring HDL in surgical patients to mitigate AKI risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Surgical Outcomes

Background:

  • Abnormal High-density Lipoprotein Cholesterol (HDL) concentrations are linked to postoperative acute kidney injury (AKI) after cardiac surgeries.
  • The association between HDL levels and AKI in non-cardiac surgery patients requires further investigation.

Purpose of the Study:

  • To analyze the relationship between preoperative serum High-density Lipoprotein Cholesterol (HDL) concentration and the occurrence of acute kidney injury (AKI) following elective non-cardiac, non-kidney surgeries.

Main Methods:

  • A single-center cohort study included 74,284 patients undergoing elective non-cardiac surgery between January 1, 2012, and December 31, 2017.
  • Preoperative serum HDL levels were assessed using multivariate logistic regression models, with propensity score weighting analysis applied.
  • The primary endpoint was the development of acute kidney injury (AKI) within 7 days postoperatively.

Main Results:

  • The incidence of postoperative AKI was 4.4% (3159 cases) among the 74,284 surgeries.
  • Preoperative serum HDL < 1.03 mmol/L was significantly associated with an increased risk of postoperative AKI (OR 1.40, P < 0.001 before weighting; OR 1.32, P < 0.001 after weighting).
  • Sensitivity analyses using different HDL cutoff values yielded consistent results, confirming the association.

Conclusions:

  • Low preoperative High-density Lipoprotein Cholesterol (HDL) levels are an independent risk factor for acute kidney injury (AKI) after non-cardiac surgery.
  • These findings underscore the potential role of HDL in predicting and possibly preventing AKI in the perioperative setting.
  • Further research is warranted to explore the underlying mechanisms and therapeutic implications of this association.
Abstract

Keywords:
Acute kidney injuryHigh-density lipoprotein cholesterolNoncardiac surgeryRisk factors

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