Lipid Parameters and the Development of Chronic Kidney Disease: A Prospective Cohort Study in Middle-Aged and Elderly Chinese Individuals

Epidemiological evidence suggests that lipid parameters are related to the progression of chronic kidney disease (CKD). Nevertheless, prospective studies that comprehensively assess the effect of routinely available lipid measures on the development of CKD are lacking. The aim of this study was to longitudinally assess the influence of lipid metabolism indicators on the presence of CKD in a large community-based population. We conducted a prospective cohort study at Sun Yat-sen Memorial Hospital, China, with 5345 patients of 40 years or older. Cox regression models were conducted, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess lipid parameters and their relationship with the incidence of CKD. During the follow-up period, 340 (6.4%) subjects developed CKD. The incidence of CKD increased progressively with quartile values of triglyceride (TG), the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and the ratio of TG to HDL-C, but decreased with HDL-C quartiles (p < 0.0001 for all trends). Pearson's correlation analysis and multiple regression analyses indicated that these parameters were also associated with various indicators of kidney function. Moreover, we found that among all the lipid parameters, TG/HDL-C emerged as the most effective predictor of CKD. In conclusion, our findings suggest that TG/HDL-C better predicts the incidence of CKD in middle-aged and elderly Chinese individuals than other lipid parameters tested in the study.