Association of combined low-density lipoprotein cholesterol and residual cholesterol stratification with all- cause and cardiovascular mortality in peritoneal dialysis patients: a multicenter retrospective cohort study

Background. Low-density lipoprotein cholesterol (LDL-C) combined with residual cholesterol (RC) can predict mortality in the general population. Studies on the effects of LDL-C combined with RC in peritoneal dialysis(PD) patients are lacking. The aim of this study was to elucidate the linkage of LDL-C and RC stratification with all-cause and cardiovascular mortality in PD patients. Methods. In this retrospective analysis of multicenter data, 3397 patients from China undergoing initial PD spanning January 1, 2005, through May 31, 2023, were involved. The included participants were orderly grouped into four cohorts in view of their baseline RC and LDL-C concentrations. The conjunction between baseline LDL-C levels combined with RC values and the cardiovascular and all-cause mortality risk in PD participants was evaluated using Fine-Grey ^, s hazard models. Results. Among 3397 recipients aging of 50.5±14.4 years , along with 57.3% male were enrolled. During a period of 17179 person-years of follow-up, 904 deaths were documented, of which 512 were caused by cardiovascular disease (CVD). Those with high LDL-C(≥2.6 mmol/L) and RC(≥0.62 mmol/L) levels exhibited a higher likelihood of all-cause mortality risk (adjusted hazards ratio [HR], 1.47; 95% confidence interval [CI],1.21 to 1.79) and cardiovascular mortality (adjusted HR, 1.55; 95% CI,1.19 to 2.01) in comparison to low levels of RC (<0.62 mmol/L) and LDL-C (<2.6mmol/L). This trend remained robust in PD patients who survived the two-year follow-up period. Conclusions. Higher levels of RC and LDL-C at the initiation of PD had significant linked with more elevated cardiovascular and all-cause mortality in PD patients.