Abstract
BACKGROUND: Cardiovascular disease (CVD) is often comorbid with chronic kidney disease (CKD). Small low-density lipoprotein cholesterol (sdLDL-C) has also been found to increase risk for CVD. The goal of the present study was to determine the nature of the relationship between sdLDL-C concentration and CVD in patients with CKD. METHODS: One-hundred and forty-five subjects (113 men and 32 women) with CKD (Stage 3 and Stage 4) participated this retrospective study. The concentration of sdLDL-C was measured in samples from 145 CKD patients between 2010 and 2012 during a four-year follow-up period. RESULTS: A total of eight fatal cardiovascular events (CVs) and 46 nonfatal CVs were registered in the four-year follow-up period. Multivariate Cox regression analysis showed that sdLDL-C [1.278, 95 % (1.019-1.598)] and sdLDL-C/LDL-C [2.456, 95 % (1.421-15.784)], at final observation, were independent risks of CVs. A Kaplan-Meier survival analysis showed that patients with sdLDL-C >38 mg/dl (logrank: 4.375, P = 0.037), and sdLDL-C/LDL-C ratio >0.3 levels (logrank: 11.94, P = 0.018) were at increased risk for CVs. CONCLUSION: The results of this study indicated that for patients suffering CKD, a significant relationship exists between an elevated sdLDL-C concentration and the risk of cardiovascular disease.