Relationship Between Cholesterol Levels and Mortality in Patients Undergoing Hemodialysis

Introduction: Cardiovascular events and mortality rates are high in chronic renal failure patients who are undergoing hemodialysis treatment. Hence, patients with a higher mortality risk must be distinguished. Dyslipidemia is more frequently reported in hemodialysis patients. Inconsistent results are obtained between the cholesterol levels and mortality of patients undergoing hemodialysis. This study aims to inspect the association between the mortality rate and the mean total cholesterol, triglyceride, and high- and low-density lipoprotein cholesterol levels.
Methods: This study involved 506 patients undergoing hemodialysis retrospectively between January 2015 and December 2019. All patients following a hemodialysis program were monitored. The lipid level data for 6-month periods were recorded until death or study end date. Patients below 18 and those who were on hemodialysis for less than 60 days were excluded.
Results: Of the 506 participants, 288 (56.9%) survived. The mean followup period was 31.7 months. High- and low-density lipoproteins, triglyceride, total cholesterol levels, and lipid-lowering drug usage were significantly higher, but the duration on hemodialysis was significantly lower in surviving patients. The regression analysis showed that age, systolic blood pressure, and treatment with erythropoietin were related with mortality.
Discussion and Conclusion: In patients undergoing hemodialysis, decreases in the mean total cholesterol, triglyceride, and high- and low-density lipoprotein cholesterol levels increased the mortality risk, while antihyperlipidemic drugs decreased the mortality risk. Lowering the lipid levels below safe levels may increase the mortality risk; because of this, the target lipid levels for hemodialysis patients must be sparely determined.

Keywords: Cholesterol; Dyslipidemias; Hemodialysis; Mortality