Lipid Profile Variations Across CKD Stages and their Association with Cardiovascular Risk: A Cross-Sectional Study

Abstract

Background
Chronic kidney disease (CKD) is a major global health concern associated with significant cardiovascular morbidity
and mortality. Dyslipidemia, a hallmark of CKD, plays a critical role in cardiovascular disease (CVD) progression.
This study evaluates lipid profile alterations and their association with cardiovascular risk across CKD stages.
Methods
This cross-sectional study included 95 patients with CKD from SCB Medical College and Hospital, Odisha, India.
Participants were classified according to CKD stages 1–5 based on eGFR. Lipid profiles, including total cholesterol
(TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), and very low density
lipoprotein (VLDL) were assessed using fasting blood samples. Cardiovascular risk was evaluated using the
Framingham risk score. Statistical analyses included the Kruskal-Wallis test, Pearson’s correlation, and multivariate
logistic regression. Survival probabilities were analyzed using Kaplan-Meier plots.
Results
HDL cholesterol declined significantly with CKD progression (p = 0.011), while total and LDL cholesterol levels were
lower in Stage 5 (p = 0.002 and p = 0.031, respectively). Triglycerides and VLDL cholesterol showed positive
correlations with cardiovascular risk (p = 0.006 and p = 0.005), whereas HDL cholesterol exhibited a negative
correlation (p = 0.002). Multivariate regression identified low HDL cholesterol (OR: 0.88, p = 0.003) and elevated
triglycerides (OR: 1.05, p = 0.01) as independent predictors of cardiovascular events. Kaplan-Meier analysis
demonstrated declining survival rates with advancing CKD stages (log-rank p < 0.05).
Conclusion
Dyslipidemia significantly contributes to cardiovascular risk in patients with CKD. Targeted lipid management,
particularly addressing HDL and triglycerides, may mitigate cardiovascular complications and improve outcomes in
patients with CKD.