Serum cholesterol and risk of end-stage renal disease in a cohort of mass screening
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
To evaluate the relative risk of end-stage renal disease (ESRD), indicated by basal serum cholesterol levels, we examined data from the 1983 community-based, mass screening registry and chronic dialysis program in Okinawa, Japan.
Data on serum cholesterol were available for a total of 38,053 subjects (17,859 men and 20,194 women), in addition to dipstick urinalysis and blood pressure data. Between 1983 and the end of 1995, we identified 99 ESRD dialysis patients (62 men and 37 women) among the screening participants.
The cumulative incidence and risk of ESRD were calculated for the following quartile definitions of serum cholesterol level: ≤167 mg/dL, 168 to 191 mg/dL, 192 to 217 mg/dL, and ≥218 mg/dL. The cumulative incidence of ESRD was 179, 216, 315, and 334 per 100,000 screened subjects in the respective serum cholesterol level quartiles. Logistic regression analysis on the prediction of ESRD by serum cholesterol level quartile was done, and the odds ratio (95% confidence interval) was 1.25 (1.04–1.49). However, the significance was lost when adjusted for the results of urinalysis or blood pressure measurements. Serum cholesterol levels were dependent on the degree of proteinuria by dipstick and blood pressure findings.
The present study suggests that serum cholesterol may not be an independent predictor of ESRD. Whether the result was due to racial difference or was organ specific remains to be determined.
- Kannel WB, Castelli WP, Gordon T. Cholesterol in the prediction of atherosclerotic disease: new perspectives based on the Framingham Study. Ann Intern Med 1979;90:85–91.
- Tyroler HA. Review of lipid-lowering clinical trials in relation to observational epidemiologic studies. Circulation 1987;76:515–522.
- Gupta S, Rifici V, Crowley S, Brownlee M, Shan Z, Schlondorff D. Interactions of LDL and modified LDL with mesangial cells and matrix. Kidney Int 1992;41: 1161–1169.
- Thomas ME, Harris KPG, Ramaswamy C, Hattersley JM, Wheeler DC, Varghese Z, Williams JD, Walls J, Moorhead JF. Simvastatin therapy for hypercholesterolemic patients with nephrotic syndrome or significant proteinuria. Kidney Int 1993;44:1124–1129.
- Kasiske BL, O'Donnell MP, Schmitz PG, Kim Y, Keane WF, Phillips F, Daniels F, Holden G. Renal injury of diet-induced hypercholesterolemia in rats. Kidney Int 1990;37:880–891.
- Krolewski AS, Warram JH, Christlieb AR. Hypercholesterolemia—a determinant of renal function loss and deaths in IDDM patients with nephropathy. Kidney Int 1994;45:S125-S131.
- Saito T, Sato H, Kudo K, Oikawa S, Shibata T, Hara Y, Yoshinaga K, Sakaguchi H. Lipoprotein glomerulopathy. Glomerular lipoprotein thrombi in a patient with hyperlipoproteinemia. Am J Kidney Dis 1989;13:148–153.
- Kannel WB, Stampfer MJ, Castelli WP, Verter J. The prognostic significance of proteinuria. The Framingham study. Am Heart J 1984;108:1347–1352. CrossRef
- Iseki K, Iseki C, Ikemiya Y, Fukiyama K. Risk of developing end-stage renal disease in a cohort of mass screening. Kidney Int 1996;49:800–805.
- Appel G. Lipid abnormalities in renal disease. Nephrology Forum. Kidney Int 1991;39:169–183.
- Tschope W, Ritz E, Suki WN, Massry SG, eds. The management of renal insufficiency in therapy of renal diseases and related disorders. In: Therapy of renal diseases and related disorders. Dordrecht, The Netherlands; Martinus Nijhoff Publishing, 1984:495–503.
- Iseki K, Kawazoe N, Osawa A, Fukiyama K. Survival analysis of dialysis patients in Okinawa, Japan (1971–1990). Kidney Int 1993;43:404–409.
- Iseki K, Ikemiya Y, Fukiyama K. Risk factors of endstage renal disease and serum creatinine in a community-based mass creening. Kidney Int 1997;51:850–854.
- Allain CC, Poon LS, Chan CSG, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem 1974;20:470–475.
- Iseki K, Kawazoe N, Fukiyama K. Serum albumin is a strong predictor of death in chronic dialysis patients. Kidney Int 1993;44:115–119.
- Iseki K, Kinjo K, Kimura Y, Osawa A, Fukiyama K. Evidence for high risk of cerebral hemorrhage in chronic dialysis patients. Kidney Int 1993;44:1086–1090.
- SAS/STAT, User's Guide. Release 6.03 ed. Cary, SAS Institute, 1988.
- Iseki K, Uchara H, Nishime K, Tokuyama K, Yoshihara K, Kinjo K, Shiohira Y, Fukiyama K. Impact of the initial levels of laboratory variables on survival in chronic dialysis patients. Am J Kidney Dis 1996;28:541–548.
- Iseki K, Ikemiya Y, Fukiyama K. Blood pressure and risk of end-stage renal disease in a screened cohort. Kidney Int 1996;49:S69-S71.
- Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulamn N, Stamler J. Blood pressure and end-stage renal disease in men. N Engl J Med 1996;334:13–18. CrossRef
- Kaysen GA, Gambertoglio J, Felts J, Hutchison FN. Albumin synthesis, albuminuria and hyperlipidemia in nephrotic patients. Kidney Int 1987;31:1368–1376.
- Bonaa KH, Thelle DS. Association between blood pressure and serum lipids in a population. The Tromso Study. Circulation 1991;83:1305–1314.
- Walker BR, Padfield PL. Subgroups of hypertensiori. In: Swales, JD (ed) The textbook of hypertension. London; Blackwell Scientific Publications, 1994:735–749.
- Silbiger SR, Neugarten J. In-depth review. The impact of gender on the progression of chronic renal disease. Am J Kidney Dis 1995;25:515–533.
- Sunagawa H, Iseki K, Nishime K, Uehara H, Toma S, Kinjo K, Fukiyama K. Epidemiologic analysis of diabetic patients on chronic dialysis. Nephron 1996;74:361–366.
- Bergstrom J, Alverstrand A, Bucht H, Gutierrez A. Progression of chronic renal failure in man is retarded with more frequent clinical follow-ups and better blood pressure control. Clin Nephrol 1986;25:1–6.
- Wakugami K, Iseki K, Kimura Y, Okumura K, Ikemiya Y, Muratani H, Fukiyama K. Relationship of serum cholesterol to the risk of acute myocardial infarction in a screened cohort in Okinawa, Japan. Jpn Circ J (in press).
- Kinjo K, Kimura Y, Shinzato Y, Tomori M, Komine Y, Kawazoe N, Takishita S, Fukiyama K, and COSMO Group. An epidemiological analysis of cardiovascular disease in Okinawa, Japan. Hypertens Res 1992;15:111–119.
- Blackburn H, Jacobs DR Jr. The ongoing natural experiment of cardiovascular disease in Japan. Circulation 1989;79:718–720.
- Barmot MG, Smith GD. Why are the Japanese living longer? Br Med J 1989;299:1547–1551. CrossRef
- Hull AR, Parker TF III. Proceedings from the morbidity, mortality and prescription of dialysis symposium, Dallas, TX, September 15 to 17, 1989. Am J Kidney Dis 1990;15:375–385.
- Remuzzi G, Bertani T. Is glomerulosclerosis a consequence of altered glomerular permeability to macromolecules? Kidney Int 1990;38:384–394.
- Burton C, Harris KPG. In-depth review. The role of proteinuria in the progression of chronic renal failure. Am J Kidney Dis 1996;27:765–775.
- Maschio G, Alberti D, Janin G, Lacatelli F, Mann JFE, Motolese M, Ponticelli C, Ritz E, Zucchelli P, and the Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group. Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. N Engl J Med 1996;334:939–945. CrossRef
- Serum cholesterol and risk of end-stage renal disease in a cohort of mass screening
Clinical and Experimental Nephrology
Volume 2, Issue 1 , pp 18-24
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- serum cholesterol
- endstage renal disease
- mass screening
- Industry Sectors
- Author Affiliations
- 1. Dialysis Unit and Third Department of Internal Medicine, University of The Ryukyus, 207 Uehara, 903-0215, Okinawa, Japan
- 2. Okinawa General Health Maintenance Association, Okinawa, Japan
- 3. Third Department of Internal Medicine, University of The Ryukyus, Okinawa, Japan