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Association between serum total cholesterol and chronic kidney disease progression in children: results from the KNOW-PedCKD

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Abstract

Background

Dyslipidemia can cause cardiovascular disease and increase the fatality rate among children with chronic kidney disease (CKD); this makes early screening and treatment of dyslipidemia crucial. This study aimed to assess the association between the changes in serum total cholesterol levels over time and the degree of CKD progression in children.

Methods

From April 2011 to August 2021, 379 of the 432 participants enrolled in the KoreaN cohort study for Outcomes in patients With Pediatric CKD (KNOW-PedCKD) were included and divided into 4 categories based on total cholesterol levels (< 170 mg/dL, acceptable; 170–199, borderline; 200–239, high; and ≥ 240, very high). Survival analysis using conventional and time-dependent Cox proportional hazards model were performed for a composite event of CKD progression (≥ 50% decrease in estimated glomerular filtration rate from baseline, a twofold increase in creatinine, or the occurrence of dialysis or kidney transplantation).

Result

The incidence of composite event of CKD progression was 96.3, 90.4, 87.3, and 270.6 cases per 1000 person-years in the acceptable, borderline, high, and very high categories, respectively. On using the time-dependent Cox proportional hazards model, the hazard ratio of the very high category was significantly higher than that of the acceptable category by 3.13 times as per univariate analysis and 2.37 times as per multivariate analysis.

Conclusions

Very high serum total cholesterol is a significant risk factor for CKD progression in children. Lowering total cholesterol levels below the very high category in children with CKD may delay the progression of CKD.

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Data availability

All data generated or analyzed during this study are included in this article.

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Funding

KNOW-PedCKD (trial registration:NCT02165878-ClinicalTrials.gov) was funded by grants 2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, 2016E3300201, 2016E3300202, 2019E320100, 2019E320101, 2019E320102, and 2022–11-007 awarded by the Research of Korea Disease Control and Prevention Agency after peer review.

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Authors and Affiliations

  1. Department of Pediatrics, Yeungnam University, College of Medicine, Daegu, South Korea

    Hee Sun Baek

  2. Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, South Korea

    Min Ji Park & Min Hyun Cho

  3. Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University, School of Medicine, Busan, South Korea

    Ji Yeon Song

  4. Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, South Korea

    Seong Heon Kim, Hee Gyung Kang & Yo Han Ahn

  5. Department of Pediatrics, Jeju National University Hospital, Jeju, South Korea

    Kyoung Hee Han

  6. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Heeyeon Cho

  7. Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea

    Keum Hwa Lee & Jae Il Shin

  8. Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, South Korea

    Young Seo Park & Joo Hoon Lee

  9. Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea

    Eujin Park

  10. Department of Pediatrics, Chonnam National University Hospital, Gwangju, South Korea

    Eun Mi Yang

Authors
  1. Hee Sun Baek
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  2. Min Ji Park
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  15. Min Hyun Cho
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Corresponding author

Correspondence to Min Hyun Cho.

Ethics declarations

Ethical approval

This study was approved by the institutional review boards of the participating centers, namely Kyungpook National University Hospital (Daegu, South Korea), Seoul National University Children’s Hospital (Seoul, South Korea), Jeju University Hospital (Jeju, South Korea), Pusan National University Children’s Hospital (Yangsan, South Korea), Severance Children’s Hospital (Seoul, South Korea), Samsung Medical Center (Seoul, South Korea), and Asan Medical Center (Seoul, South Korea). Children with CKD aged < 18 years were enrolled in this study after informed consent had been obtained from their parents or guardians.

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The authors declare that they have no conflicts of interest.

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Baek, H.S., Park, M.J., Song, J.Y. et al. Association between serum total cholesterol and chronic kidney disease progression in children: results from the KNOW-PedCKD. Pediatr Nephrol 38, 4101–4109 (2023). https://doi.org/10.1007/s00467-023-06033-6

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  • DOI: https://doi.org/10.1007/s00467-023-06033-6

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