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Association between Remnant Cholesterol and All-Cause and Cardiovascular Mortality Risk in Chronic Kidney Disease Patients Over 60: A Cohort Study Based on NHANES 2001-2018

yao, j.; Lin, C.; Xu, Q.; Li, G.; Lin, Y.

2025-02-13 endocrinology
10.1101/2025.02.12.25322142 medRxiv
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ObjectiveChronic kidney disease (CKD) patients face significant mortality risks, and remnant cholesterol (RC) may be a critical prognostic indicator. This study aimed to explore the association between RC and all-cause and cardiovascular mortality risks in CKD patients. MethodsThis prospective cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2001-2018, including 1,606 CKD patients aged over 60. Cox proportional hazards models were employed to assess the association between RC and all-cause and cardiovascular mortality, with multi-model adjustments and subgroup analyses. ResultsDuring 93.9 months of follow-up, 932 all-cause mortality events (58.0%) and 283 cardiovascular mortality events (17.6%) were observed. Each logarithmic unit increase in RC was associated with a significant 41% reduction in all-cause mortality risk (adjusted HR: 0.59, 95% CI: 0.40-0.87, P=0.0079). Subgroup analyses revealed significantly reduced all-cause mortality risks in women (HR=0.71), hypertensive patients (HR=0.75), and type 2 diabetes patients (HR=0.66). ConclusionIn CKD patients, RC is significantly associated with reduced all-cause mortality risk, providing a new perspective for individualized mortality risk assessment.

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