Lipid control in a cohort of patients with cardiorenal disease (LIPID-REN): a subanalysis of the CARDIOREN registry
TL;DR
In patients with advanced CKD, lipid control was below cardiology guideline recommendations for patients at very high cardiovascular disease risk, particularly among those without ASCVD and in women.
Abstract
Advanced chronic kidney disease (CKD) confers a very high cardiovascular disease (CVD) risk, requiring comprehensive risk factor assessment. However, real-world data on current practices in patients with cardiorenal disease remain limited. We aimed to evaluate the control of cardiovascular risk factors, with a focus on lipid management, in a contemporary cardiorenal cohort. This cross-sectional analysis was conducted within the Cardioren Registry, which enrolled patients with chronic heart failure from 13 tertiary hospitals in Spain (2021–2022). Of 1,107 patients, 885 with complete data on LDL-C, albuminuria, and atherosclerotic cardiovascular disease (ASCVD) were eligible. The present analysis was restricted to the patients who met the definition of advanced CKD, defined as eGFR <30 mL/min/1.73 m² or eGFR 30–45 mL/min/1.73 m² with albuminuria >30 mg/g. ASCVD was defined as prior ischemic heart disease, stroke, or peripheral arterial disease. The proportion of patients with LDL-C <55 mg/dL was assessed. Multivariable logistic regression models, including a parsimonious primary model and sensitivity analyses, were used to identify factors associated with lower LDL-C levels. Advanced CKD was present in 221 patients (25%); median age was 79 years, 58.8% were male, and 52.9% had ASCVD. Median LDL-C was 73 mg/dL, and only 22.6% achieved a LDL-C below 55 mg/dL. Achievement of LDL-C <55 mg/dL was significantly lower in patients without ASCVD compared with those with ASCVD (13.4% vs. 30.7%; p=0.002). In multivariable analysis, ASCVD was independently associated with a higher likelihood of achieving LDL-C <55 mg/dL, whereas female sex was independently associated with a lower likelihood of achieving this level. In patients with advanced CKD, lipid control was below cardiology guideline recommendations for patients at very high cardiovascular disease risk, particularly among those without ASCVD and in women.