Epidemiology
High Lp(a) independently raises cardiovascular mortality risk in 1492 peritoneal dialysis patients (J Clin Lipidol 2020)
Original title: Serum lipoprotein(a) and risk of mortality in patients on peritoneal dialysis
In a retrospective cohort of 1492 incident peritoneal dialysis patients followed for a median 45.1 months, 402 all-cause and 210 cardiovascular deaths occurred. Compared with the second tertile of Lp(a), the first and third tertiles were both associated with increased all-cause mortality (hazard ratio 1.33, 95% CI 1.01-1.75, P=.041; and 1.53, 95% CI 1.18-1.98, P=.001, respectively), and the third tertile carried an 80% increased risk of cardiovascular mortality (HR 1.80, 95% CI 1.26-2.56, P=.001). Per log-unit increase in Lp(a), hazard ratios were 1.53 (95% CI 1.05-2.22, P=.027) for all-cause mortality and 2.41 (95% CI 1.44-4.03, P<.001) for cardiovascular mortality. The findings suggest both low and high Lp(a) levels mark all-cause mortality risk, but only high Lp(a) independently predicts cardiovascular mortality in peritoneal dialysis patients.
Original abstract
Background: Elevated serum lipoprotein(a) [Lp(a)] level is an independent risk factor for atherosclerotic diseases in the general population and hemodialysis patients. However, the association between Lp(a) levels and mortality has received little attention in peritoneal dialysis (PD) patients.
Objective: The objective of the study was to evaluate the association of Lp(a) levels with all-cause and cardiovascular (CV) mortality in PD patients.
Methods: This retrospective cohort study was conducted in PD patients enrolled from January 1, 2006 to December 31, 2015, and followed until December 31, 2018. Cox regression models were performed to assess the association of serum Lp(a) levels with all-cause and CV mortality in PD patients.
Results: In total, 1492 incident PD patients were eligible for the study. During a median follow-up period of 45.1 months, 402 all-cause and 210 CV deaths occurred. Multivariate Cox regression analysis revealed that the first and third tertiles of Lp(a) levels were significantly associated with increased risk for all-cause mortality [hazard ratio (HR) = 1.33, 95% confidence interval (95% CI) = 1.01-1.75, P = .041; HR = 1.53, 95% CI = 1.18-1.98, P = .001, respectively] when compared with the second tertile, and the third tertile of Lp(a) level was independently associated with an 80% increased risk of CV mortality (HR = 1.80, 95% CI = 1.26-2.56, P = .001). Moreover, our results showed that the HRs per log unit higher Lp(a) level for all-cause and CV mortality were 1.53 (95% CI = 1.05-2.22, P = .027) and 2.41 (95% CI = 1.44-4.03, P < .001), respectively.
Conclusions: Our results suggest that both low and high serum Lp(a) levels are risk markers for all-cause death, but only a higher baseline serum Lp(a) level is an independent risk factor for CV mortality in PD patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.