Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients

Abstract Background In individuals receiving continuous ambulatory peritoneal dialysis (CAPD), remnant cholesterol (RC) and high-density lipoprotein cholesterol (HDL-C) levels significantly influence clinical outcomes. Current clinical practice might benefit from assessing these two lipid markers in...

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Main Authors: Zebin Wang, Sibing Huang, Na Tian, Qingdong Xu, Xiaojiang Zhan, Fenfen Peng, Xiaoyang Wang, Ning Su, Xiaoran Feng, Xingming Tang, Xianfeng Wu, Qian Zhou, Jianbo Liang, Jiao Li, Yueqiang Wen
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Lipids in Health and Disease
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Online Access:https://doi.org/10.1186/s12944-025-02522-9
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Summary:Abstract Background In individuals receiving continuous ambulatory peritoneal dialysis (CAPD), remnant cholesterol (RC) and high-density lipoprotein cholesterol (HDL-C) levels significantly influence clinical outcomes. Current clinical practice might benefit from assessing these two lipid markers in combination when evaluating cardiovascular disease (CVD) and all-cause mortality. Therefore, this research sought to examine how the RC/HDL-C ratio correlates with both CVD and all-cause mortality rates among individuals receiving CAPD treatment. Methods Between January 1, 2005 and December 31, 2016, a multi-center retrospective analysis of 2006 CAPD patients from five peritoneal dialysis hospitals in China was conducted. Participants were split into two subgroups in accordance with the baseline serum RC/HDL-C ratio restricted cubic spline cutoff value. The correlations between mortality and RC/HDL-C ratio were examined through case-specific hazard modeling. Results The observation period documented 549 all-cause fatalities, with cardiovascular deaths accounting for 269 cases. The Kaplan-Meier analysis revealed statistically significant divergence in both all-cause mortality (log rank test P < 0.001) and CVD mortality (log rank test P = 0.003). Elevated RC/HDL-C ratios showed increased hazard ratios (HR) for all-cause mortality (1.335, 95% CI, 1.112–1.603, P = 0.002) and CVD mortality (1.319, 95% CI, 1.013–1.717, P = 0.040) compared to lower ratio counterparts. Nevertheless, no statistically meaningful association was found between CVD mortality and either RC (HR: 1.296, 95% CI, 0.992–1.691, P = 0.057) or HDL-C (HR: 0.887, 95% CI, 0.680–1.157, P = 0.376). Conclusion The RC/HDL-C ratio independently predicts mortality in CAPD patients, persisting as a significant prognostic marker after multivariable adjustment.
ISSN:1476-511X