Serum triglycerides and risk for death in Stage 3 and Stage 4 chronic kidney disease

An elevated triglyceride level is associated with cardiovascular and all-cause mortality in the general population. The associations between serum triglyceride and all-cause mortality among patients with chronic kidney disease (CKD) are unclear. Patients with Stage 3 and Stage 4 CKD (estimated glomerular filtration rate 1559 mL/min/1.73 m(2)) who had serum triglycerides measured prior to being classified as CKD were included. We examined the associations of serum triglyceride levels with all-cause mortality among 25 641 Stage 3 and Stage 4 CKD patients using Cox proportional hazard models and KaplanMeier survival curves. In the Cox model, after adjusting for relevant covariates including other lipid parameters, serum triglyceride level 150199 mg/dL was not associated with death [hazard ratio (HR) 1.00, 95 confidence interval (95 CI) 0.921.10] relative to serum triglyceride 150 mg/dL while serum triglyceride epsilon 200 mg/dL was associated with a 11 increased hazard for death (95 CI 1.011.22). Age modified the association between serum triglyceride levels epsilon 200 mg/dL and mortality with patients 65 years having a 38 higher hazard for death (95 CI 1.151.65) and epsilon 65 years with no increased risk for death (HR 0.97, 95 CI 0.881.08, P for interaction 0.001). When serum triglycerides were examined as a continuous log-transformed variable, similar associations with mortality were noted. Serum triglyceride epsilon 200 mg/dL was independently associated with all-cause mortality in Stage 3 and Stage 4 CKD patients aged 65 years but not among patients of age epsilon 65 years. Future studies should confirm these findings and examine the mechanisms that may explain these associations.