Cholesterol Synthesis, Cholesterol Absorption, and Mortality in Hemodialysis Patients

Rogacev KS et al. – This analysis of markers of cholesterol metabolism characterizes hemodialysis patients as cholesterol absorbers. In longitudinal analysis, higher levels of cholestanol were associated with all–cause mortality.

Methods

• In 113 HD patients, lathosterol was measured as a marker of cholesterol synthesis and cholestanol was measured as a marker of cholesterol absorption via gas chromatography.
• Controls were 229 healthy persons.
• Overall survival in HD patients was recorded over 3.4-year follow-up.

Results

• Compared with controls, HD patients had lower lathosterol and higher cholestanol levels (P<0.001 for both).
• During follow-up, 58 patients died; higher cholestanol (indicating higher cholesterol absorption) predicted poor outcome among HD patients in multivariate Cox regression analysis after adjustment for potential confounders (hazard ratio for cholestanol above median, 2.24 [95% confidence interval (CI), 1.29–3.89]; P=0.004), whereas lower lathosterol (indicating lower cholesterol synthesis) did not (hazard ratio for lathosterol below median, 1.43 [95% CI, 0.81–2.50]; P=0.22).

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