title: Serum triglycerides and risk for death in Stage 3 and Stage 4 chronic kidney disease.
abstract: BACKGROUND
  An elevated triglyceride level is associated with cardiovascular and all-cause mortality in the general population. The associations between serum triglyceride and all-cause mortality among patients with chronic kidney disease (CKD) are unclear.
  
  
  METHODS
  Patients with Stage 3 and Stage 4 CKD (estimated glomerular filtration rate 15-59 mL/min/1.73 m(2)) who had serum triglycerides measured prior to being classified as CKD were included. We examined the associations of serum triglyceride levels with all-cause mortality among 25 641 Stage 3 and Stage 4 CKD patients using Cox proportional hazard models and Kaplan-Meier survival curves.
  
  
  RESULTS
  In the Cox model, after adjusting for relevant covariates including other lipid parameters, serum triglyceride level 150-199 mg/dL was not associated with death [hazard ratio (HR) 1.00, 95% confidence interval (95% CI) 0.92-1.10] relative to serum triglyceride <150 mg/dL while serum triglyceride ≥ 200 mg/dL was associated with a 11% increased hazard for death (95% CI 1.01-1.22). Age modified the association between serum triglyceride levels ≥ 200 mg/dL and mortality with patients <65 years having a 38% higher hazard for death (95% CI 1.15-1.65) and ≥ 65 years with no increased risk for death (HR 0.97, 95% CI 0.88-1.08, P for interaction <0.001). When serum triglycerides were examined as a continuous log-transformed variable, similar associations with mortality were noted.
  
  
  CONCLUSIONS
  Serum triglyceride ≥ 200 mg/dL was independently associated with all-cause mortality in Stage 3 and Stage 4 CKD patients aged <65 years but not among patients of age ≥ 65 years. Future studies should confirm these findings and examine the mechanisms that may explain these associations.
authors.affiliation: Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. navanes@ccf.org
authors.forename: Sankar D
authors.initials: SD
authors.lastname: Navaneethan
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Schold
authors.forename: Susana
authors.initials: S
authors.lastname: Arrigain
authors.forename: George
authors.initials: G
authors.lastname: Thomas
authors.forename: Stacey E
authors.initials: SE
authors.lastname: Jolly
authors.forename: Emilio D
authors.initials: ED
authors.lastname: Poggio
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schreiber
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sarnak
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Nally
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000145:classification / Q000401:mortality*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D014280:Triglycerides