Higher Triglycerides Linked With Lower Mortality in Early Dialysis

Veteran patients with levels below 100 mg/dL had a 26% higher risk of mortality compared with patients with triglyceride levels of 150-200 mg/dL.
Veteran patients with levels below 100 mg/dL had a 26% higher risk of mortality compared with patients with triglyceride levels of 150-200 mg/dL.

SAN DIEGO—Higher triglyceride levels are associated with better patient survival during the transition to dialysis, according to a new study of U.S. veterans presented at Kidney Week.

Previous research found higher rates of early death among non-dialysis chronic kidney disease patients with triglyceride levels below 115 mg/dL, so investigators led by Elani Streja, PhD, MPH, and Kamyar Kalantar-Zadeh, MD, MPH, PhD, nephrology faculty investigators at the University of California Irvine School of Medicine, examined outcomes in patients transitioning to dialysis care. Among 15,342 veteran patients (average age 69) starting dialysis, 74% had diabetes as the cause of end-stage renal disease (ESRD).

Investigators found that average triglyceride levels over the 6 months prior to dialysis were inversely related with mortality from all causes during the first 3 months of dialysis. Veterans with triglyceride levels below 100 mg/dL had a greater risk of premature death in early dialysis compared with patients who had triglyceride levels of 150-200 mg/dL. The results were adjusted for age, sex, race, ethnicity, cause of ESRD, and region of residence. More than a quarter of patients were African American and 7% were Hispanic.

The researchers also examined outcomes by age. Among veterans older than age 65 starting dialysis, triglyceride levels below 100 mg/dL were associated with higher risk of post-ESRD mortality, whereas higher triglyceride levels 250 mg/dL and above were linked with improved survival.

These associations may be related to nutritional status in the final months immediately prior to transition to ESRD, according to the investigators. Patients with superior nutritional status may have greater survival, although a direct impact of triglyceride on survival as a biologically plausible factor cannot be ruled out.

Further research examining other factors, such as lipid-lowering treatments, are needed to better understand these associations, the researchers noted.

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