Effect of Lipid Abnormality on CKD Progression from Moderate to Severe Stage: Application of Flexible Parametric Proportional-Hazards and Proportional-Odds Models


Lipid Disorders
Flexible Parametric Model
Proportional Hazards Model
Proportional Odds Model

How to Cite

Ashraf Mozafari, A. ., Mansournia, M. A. ., Sayehmiri, K. ., Ghiasi, B. ., Yaseri, M. ., & Azami, G. . (2020). Effect of Lipid Abnormality on CKD Progression from Moderate to Severe Stage: Application of Flexible Parametric Proportional-Hazards and Proportional-Odds Models. Iranian Red Crescent Medical Journal, 22(7). Retrieved from https://ircmj.com/index.php/IRCMJ/article/view/728


Background: Lipid disorders are a well-documented risk factor for chronic kidney disease (CKD), but the impact of lipid abnormal- ities in the progression of the disease remains mixed.

Objectives: The current study aimed to extend the existing knowledge about the effect of lipid disorders in disease progression from moderate to severe stage using Flexible parametric survival models.

Methods: This retrospective cohort study included 308 moderate CKD patients who received the nephrologist follow-up visits at the nephrology clinic, Ilam (Iran), from 2012 to 2019. The survival time was determined based on the time medically diagnosed with moderate stages (GFR = 59 - 55 mL/min per 1.73 m2) to the time of progression to the severe stage (GFR = 29 - 25 mL/min per 1.73 m2) hazard using flexible parametric survival models.

Results: In univariate analysis, high levels of TG, LDL, and cholesterol were important risk factors which affect the CKD progression. The hazard of patients with TG > 200 mg/dL was 1.69 times higher than patients with desirable TG levels (P = 0.09). Moreover, for patients with LDL > 160 mg/dL, the hazard was 2.12 times higher than patients with desirable LDL levels (P = 0.01). The hazard of patients with total cholesterol levels > 240 mg/dL was 2.10 times higher than patients with desirable cholesterol levels (P = 0.003). The adjusted model was shown to better fit the PH model. Cholesterol levels > 240 mg/dL remains a significant risk factor for CKD progression (P = 0.03).

Conclusions: Effective treatment programs should pay closer attention to screening and treatment of hyperlipidemia in patients diagnosed with moderate CKD.



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