[MO-65] Presentation Awards
Impact of HDL to major adverse limb event in end-stage renal disease on hemodialysis due to diabetic nephropathy. from PREDICT study
Background: Increased low-density lipoprotein cholesterol (LDL-C) level has long been recognized as an important causal risk factor for atherosclerotic cardiovascular (CV) disease. Low levels of serum high-density lipoprotein cholesterol (HDL-C) have been shown to be associated with increased risk of coronary heart disease (CHD).
Aim: To investigate 2-year natural history of end-stage renal disease (ESRD) and predictor of death and major adverse limb event (MALE).
Methods: In the (Prospective REgistry with the DIalysis patient due to diabetes to prevent the CriTical limb ischemia) PREDICT study, a multicenter prospective observational study, we enrolled173 consecutive patients on HD due to diabetic nephropathy between April 2012 and August 2013 from 13 institutions. We investigated, performance status, ABI, lower limb artery lesions by duplex ultra sound, at every 6 months for 2 years. Limb artery stenosis defined as peak systolic velocity ratios PSV > 200m/s. Low HDL defined as less than 40 mg/dl. High LDL defined as over 70mg/dl
Result: The2-year survival rate was 85.1%. The occurrence of de novo lower limb arteries was 7.6%, and freedom from CLI was 91.5%. The low HDL (<40 mg/dl) patients’ mortality was higher than high HDL patients’ (21.1% vs. 7.8%, p= 0.014). The high HDL (>40 mg/dl) patients’ MALE was higher than high HDL patients’ (36% vs. 11.2%, p= 0.0005). Cox regression was used to evaluate the association between baseline ABI and mortality, CLI. The low HDL was strong predictor for MALE (HR3.2; 95%CI, 1.51-7.56 p=0.0023). The LDL level was not associate any adverse events in this study.
Conclusion: This study revealed high mortality, and high incidence rate of stroke, CLI in HD patients with diabetic nephropathy. HDL level is useful for the prediction of mortality or adverse events for HD patients.
Aim: To investigate 2-year natural history of end-stage renal disease (ESRD) and predictor of death and major adverse limb event (MALE).
Methods: In the (Prospective REgistry with the DIalysis patient due to diabetes to prevent the CriTical limb ischemia) PREDICT study, a multicenter prospective observational study, we enrolled173 consecutive patients on HD due to diabetic nephropathy between April 2012 and August 2013 from 13 institutions. We investigated, performance status, ABI, lower limb artery lesions by duplex ultra sound, at every 6 months for 2 years. Limb artery stenosis defined as peak systolic velocity ratios PSV > 200m/s. Low HDL defined as less than 40 mg/dl. High LDL defined as over 70mg/dl
Result: The2-year survival rate was 85.1%. The occurrence of de novo lower limb arteries was 7.6%, and freedom from CLI was 91.5%. The low HDL (<40 mg/dl) patients’ mortality was higher than high HDL patients’ (21.1% vs. 7.8%, p= 0.014). The high HDL (>40 mg/dl) patients’ MALE was higher than high HDL patients’ (36% vs. 11.2%, p= 0.0005). Cox regression was used to evaluate the association between baseline ABI and mortality, CLI. The low HDL was strong predictor for MALE (HR3.2; 95%CI, 1.51-7.56 p=0.0023). The LDL level was not associate any adverse events in this study.
Conclusion: This study revealed high mortality, and high incidence rate of stroke, CLI in HD patients with diabetic nephropathy. HDL level is useful for the prediction of mortality or adverse events for HD patients.