Composite Lipid Parameters are Optimal in Predicting Chronic Kidney Disease Prognosis

Abstract

Abstract Background Lipid management in clinic is critical to the prevention and treatment of CKD, while the manifestations of fat metabolism vary in type and have flexible correlations with CKD prognosis. Purpose Explore correlations between the widely used indicators of lipid metabolism in clinic and CKD prognosis; provide a reference for lipid management and treatment among non-dialysis CKD stages 3–5. Methods This is a retrospective cohort study utilizing the SMP-CKD database of 794 individuals with CKD stages 3–5. Variables with P < 0.10 in univariate Poisson models were induced to construct several timescale-based Poisson models with a stepwise regression according to lipid manifestation categories. We selected the best model via AIC, AUC and ROC and confirmed the independent relative exposures via RRs (95% CI). Subgroup analysis and sensitivity analysis were performed to assess the interaction effects and robustness. Results 255 individuals reached the composite outcome. Median follow-up duration was 2.03 [1.06, 3.19] years. Median age was 58.35 [48.50, 66.69] years with a median eGFR of 33.68 [17.55, 47.81] ml/min/1.73 m2. The fully adjusted category-based Poisson Model 4 in Dataset 5 had the largest AUC (0.717 [0.684, 0.751]) with P for ROC < 0.05. TC (1.158 [1.056, 1.271], P = 0.002) and PBF (0.948 [0.906, 0.992], P = 0.021) were significant factors of composite outcome and no manual measurements had any statistically significance. The