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J Am Soc Nephrol 14:2084-2091, 2003
© 2003 American Society of Nephrology

Cholesterol and the Risk of Renal Dysfunction in Apparently Healthy Men

Elke S. Schaeffner*,{ddagger},¶, Tobias Kurth*,#,{ddagger}, Gary C. Curhan{dagger},{ddagger}, Robert J. Glynn*,§, Kathryn M. Rexrode*, Colin Baigent{ddagger}{ddagger}, Julie E. Buring*,{ddagger},** and J. Michael Gaziano*,#,@,{dagger}{dagger}

Divisions of *Preventive Medicine, and #Aging, and @Cardiovascular Disease, and {dagger}Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston; {ddagger}Department of Epidemiology and §Biostatistics, Harvard School of Public Health, Boston; **Department of Ambulatory Care and Prevention, Harvard Medical School, Boston; {dagger}{dagger}Massachusetts Veterans Epidemiology Research and Information Center, VA Healthcare System, Boston, Massachusetts; Department of Nephrology, University of Freiburg, Germany; and {ddagger}{ddagger}Clinical Trial Service Unit, Oxford University, Oxford, United Kingdom.

Correspondence to Dr. Tobias Kurth, Brigham and Women’s Hospital, Division of Preventive Medicine, 900 Commonwealth Avenue East, Boston, MA 02215-1204. Phone: 617-732-8355; Fax: 617-731-3843;

ABSTRACT. Despite extensive knowledge about abnormal lipid patterns in patients with end-stage renal disease, the association between cholesterol and the development of renal dysfunction is unclear. We evaluated this association in a prospective cohort study among 4,483 initially healthy men participating in the Physicians’ Health Study who provided blood samples in 1982 and 1996. Main outcome measures were elevated creatinine, defined as >=1.5 mg/dl (133 µmol/L), and reduced estimated creatinine clearance, defined as <=55 ml/min. Cholesterol parameters included total cholesterol (<200, 200 to 239, and >=240 mg/dl), HDL (<40 or >=40 mg/dl), total non-HDL cholesterol, and the ratio of total cholesterol to HDL. We used logistic regression to calculate age- and multivariable adjusted odds ratios as a measure for the relative risk. After 14 yr, 134 men (3.0%) had elevated creatinine and 244 (5.4%) had reduced creatinine clearance. The multivariable relative risk for elevated creatinine was 1.77 (95% confidence interval [CI], 1.10 to 2.86) for total cholesterol >=240 mg/dl, 2.16 (95% CI, 1.42 to 3.27) for HDL <40 mg/dl, 2.34 (95% CI, 1.34 to 4.07) for the highest quartile of total cholesterol/HDL ratio (>=6.8), and 2.16 (95% CI, 1.22 to 3.80) for the highest quartile of non-HDL cholesterol (>=196.1). Similar although smaller associations were observed between cholesterol parameters and reduced creatinine clearance. Elevated total cholesterol, high non-HDL cholesterol, a high ratio of total cholesterol/HDL, and low HDL in particular were significantly associated with an increased risk of developing renal dysfunction in men with an initial creatinine <1.5 mg/dl. E-mail: tkurth@rics.bwh.harvard.edu




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