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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author 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
author_facet 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
author_sort Zebin Wang
collection DOAJ
description 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.
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spelling doaj-art-958b881d4d2d47f690688b076895dedc2025-08-20T03:41:43ZengBMCLipids in Health and Disease1476-511X2025-03-0124111110.1186/s12944-025-02522-9Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patientsZebin Wang0Sibing Huang1Na Tian2Qingdong Xu3Xiaojiang Zhan4Fenfen Peng5Xiaoyang Wang6Ning Su7Xiaoran Feng8Xingming Tang9Xianfeng Wu10Qian Zhou11Jianbo Liang12Jiao Li13Yueqiang Wen14Department of Nephrology, The Second Affiliated Hospital, Guangzhou Medical UniversityDepartment of Nephrology, The Second Affiliated Hospital, Guangzhou Medical UniversityDepartment of Nephrology, General Hospital of Ningxia medical universityDepartment of Nephrology, Jiangmen Central HospitalDepartment of Nephrology, The First Affiliated Hospital of Nanchang UniversityDepartment of Nephrology, Zhujiang Hospital, Southern Medical UniversityDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou UniversityDepartment of Hematology, The Sixth Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Nephrology, Jiujiang NO. 1 People’s HospitalDepartment of Nephrology, Dongguan Songshan Lake Tungwah HospitalDepartment of Nephrology, Affiliated Sixth People’s Hospital, Shanghai Jiao Tong UniversityDepartment of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat- sen UniversityDepartment of Nephrology, The Second Affiliated Hospital, Guangzhou Medical UniversityDepartment of Nephrology, The Second Affiliated Hospital, Guangzhou Medical UniversityDepartment of Nephrology, The Second Affiliated Hospital, Guangzhou Medical UniversityAbstract 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.https://doi.org/10.1186/s12944-025-02522-9LipidsCholesterolHigh-density lipoproteinPeritoneal dialysisCardiovascular diseaseMortality
spellingShingle 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
Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients
Lipids in Health and Disease
Lipids
Cholesterol
High-density lipoprotein
Peritoneal dialysis
Cardiovascular disease
Mortality
title Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients
title_full Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients
title_fullStr Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients
title_full_unstemmed Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients
title_short Association of the remnant cholesterol to high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients
title_sort association of the remnant cholesterol to high density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients
topic Lipids
Cholesterol
High-density lipoprotein
Peritoneal dialysis
Cardiovascular disease
Mortality
url https://doi.org/10.1186/s12944-025-02522-9
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