JMIR Publications

ABSTRACT

Background:

The relationship between Lipoprotein (a) (Lp(a)) and risk of chronic kidney disease (CKD) remained under debate. Evidence suggested heterogeneous risks of kidney disease in participants with different renal function indicators even within normal range.

Objective:

We aimed to investigate the joint associations between different renal function indicators and Lp(a) regarding risks of incident CKD in the general population.

Methods:

A total of 329,415 participants without previous CKD from the UK Biobank cohort were included for analysis. Baseline Lp(a) was measured by an immunoturbidimetric assay and categorized into low (< 75 nmol/L) and high (≥ 75 nmol/L) groups. Baseline urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were used to evaluate participants’ baseline renal function. Multivariable Cox regression models were used to assess the relationship between Lp(a), renal function indicators and risk of CKD.

Results:

There were 6,003 incident CKD events documented during a median follow up of 12.5 years. Significant interaction was found between Lp(a) and UACR regarding CKD risk but not between Lp(a) and eGFR. When compared with low Lp(a) & low-normal UACR group (< 10 mg/g), non-significant association was observed between high Lp(a) & low-normal UACR group and CKD risk (HR = 0.98, 95% CI: 0.90 - 1.08), whereas high-normal UACR (≥ 10 mg/g) groups were significantly associated with increased risks of CKD. Among those with high-normal UACR, high Lp (a) was associated with a significant increase in CKD risk (HR = 1.14, 95% CI: 1.03 - 1.26).

Conclusions:

A significant interaction was observed between Lp(a) and UACR regarding CKD risk. High Lp(a) was significantly associated with an increased CKD risk among those with high-normal UACR but not low-normal UACR, suggesting Lp(a) as a risk factor for CKD after taking UACR into account.