Evidence map›Paper›PMID 29361496›Full record

ArticleJournal of clinical lipidology

Associations of lipoproteins with cardiovascular and infection-related outcomes in patients receiving hemodialysis.

George A Kaysen, Barbara Grimes, Lorien S Dalrymple, Glenn M Chertow, Julie H Ishida, Cynthia Delgado, Mark Segal, Janet Chiang, Tjien Dwyer, Kirsten L Johansen

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical lipidology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

George A KaysenDivision of Nephrology, Department of Medicine, University of California Davis School of Medicine, Davis, CA, USA; Department of Biochemistry and Molecular Medicine, University of California Davis School of Medicine, Davis, CA, USA. Electronic address: gakaysen@ucdavis.edu.
Barbara GrimesDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Lorien S DalrympleFresenius Medical Care North America, Waltham, MA, USA.
Glenn M ChertowDivision of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Julie H IshidaDivision of Nephrology, Department of Medicine, University of California, San Francisco, CA, USA; Nephrology Section, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
Cynthia DelgadoDivision of Nephrology, Department of Medicine, University of California, San Francisco, CA, USA; Nephrology Section, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
Mark SegalDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Janet ChiangEndocrinology Section, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Division of Endocrinology, Department of Medicine, University of California, San Francisco, CA, USA.
Tjien DwyerDivision of Nephrology, Department of Medicine, University of California Davis School of Medicine, Davis, CA, USA.
Kirsten L JohansenDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; Division of Nephrology, Department of Medicine, University of California, San Francisco, CA, USA; Nephrology Section, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
University of California, San Francisco · USSan Francisco VA Medical Center · USUniversity of California, Davis · USFresenius Medical Care (United States) · USStanford University · US

Funding

Predictors and outcomes of frailty in dialysis patientsR01DK107269 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHANSEN, KIRSTEN L. · 2016 to 2019
$1.8M
Prevalence and Impact of Frailty among Dialysis PatientsK24DK085153 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHANSEN, KIRSTEN L. · 2010 to 2021
$1.5M
Facilitating Appropriate Analgesic Prescription in Hemodialysis PatientsK23DK103963 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ISHIDA, JULIE · 2015 to 2018
$621k
The Effects of Frailty on Chronic Kidney DiseaseIK2CX000527 · VA · VETERANS AFFAIRS MED CTR SAN FRANCISCO · PI DELGADO, CYNTHIA · 2012 to 2016
–
CSRD VA IK2 CX000527NIDDK NIH HHS K23 DK103963NIDDK NIH HHS K24 DK085153NIDDK NIH HHS R01 DK107269
6 · The paper itself

Abstract

backgroundIn hemodialysis (HD) patients, higher lipid levels are associated with lower mortality. Lipid-lowering therapy does not reduce all-cause mortality or cardiovascular (CV) mortality. Lipoproteins play a role in the innate immune system. Our objective was to determine whether protection from infection might counterbalance adverse CV outcomes associated with lipoproteins.

methodsWe examined associations between serum apolipoprotein (Apo) A1, B, C2, C3, high-density lipoprotein and low-density lipoprotein (LDL) cholesterol and triglyceride levels and infectious mortality or hospitalization, CV mortality or hospitalization, and all-cause mortality in 433 prevalent HD patients. Cox models with time-varying apolipoprotein concentrations collected every 6 months for up to 2 years were used for analyses.

resultsMedian follow-up time for all-cause mortality was 2.7 years (25th-75th percentile range: 2.2-3.4 years). One hundred seventy-nine (41%) patients had an infection-related event. In multivariable models, higher Apo B and LDL were associated with lower risks of infection-related outcomes (hazard ratio Apo B 0.92 [95% confidence interval 0.86-0.99 per 10 mg/dL, P = .03]; hazard ratio LDL 0.93 [95% confidence interval 0.87-1.00 per 10 mg/dL, P = .05]). Sixty-three (15%) participants had a CV-related event. No significant associations were observed between lipoproteins and CV outcomes. Eighty-seven (20%) participants died. Higher Apo A1, Apo B, and Apo C3 were associated with lower risks of all-cause mortality. There was no interaction between the use of lipid-lowering medication and any of the outcomes.

conclusionAssociations of lipoproteins with lower risk of serious infection accompanied by no significant association with CV events may help to explain the paradoxical association between lipids and survival and lack of benefit of lipid-lowering therapies in HD.

Indexed as

AdultAgedApolipoproteinsCardiovascular DiseasesCholesterolCholesterol, LDLCohort StudiesFemaleHumansInfectionsLipoproteinsMaleMiddle AgedProportional Hazards ModelsRenal DialysisSurvival RateApolipoproteinsCholesterolCholesterol, LDLLipoproteinsTriglyceridesACTIVE/ADIPOSEApolipoprotein BApolipoprotein C2CardiovascularInfectionLDLLipoproteinsUSRDS

Identifiers

PMID29361496
PMCPMC5880742
OpenAlexW2778373162

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.