• Roberto Pontremoli, Giovambattista Desideri, Marcello Arca, Pier Luigi Temporelli, Valentina Perrone, Melania Dovizio, Claudio Borghi, EspostiLuca DegliLDCliCon s.r.l. Società Benefit, Health, Economics & Outcomes Research, Bologna, Italy., and on the behalf of Local Health Units Group.
• Department of Internal Medicine and Medical Specialties, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genoa, Italy. Electronic address: roberto.pontremoli@unige.it.
• Eur. J. Intern. Med. 2023 May 1; 111: 909690-96.

BackgroundThis analysis investigated the role of hypertriglyceridemia on renal function decline and development of end-stage kidney disease (ESKD) in a real-world clinical setting.MethodsA retrospective analysis using administrative databases of 3 Italian Local Health Units was performed searching patients with at least one plasma triglyceride (TG) measurement between 2013 and June 2020, followed-up until June 2021. Outcome measures included reduction in estimated glomerular filtration rate (eGFR) ≥30% from baseline and ESKD onset. Subjects with normal (normal-TG), high (HTG) and very high TG levels (vHTG) (respectively <150 mg/dL, 150-500 mg/dL and >500 mg/dL) were comparatively evaluated.ResultsOverall 45,000 subjects (39,935 normal-TGs, 5,029 HTG and 36 vHTG) with baseline eGFR of 96.0 ± 66.4 mL/min were considered. The incidence of eGFR reduction was 27.1 and 31.1 and 35.1 per 1000 person-years, in normal-TG, HTG and vHTG subjects, respectively (P<0.01). The incidence of ESKD was 0.7 and 0.9 per 1000 person-years, in normal-TG and HTG/vHTG subjects, respectively (P<0.01). Univariate and multivariate analyses revealed that HTG subjects had a risk of eGFR reduction or ESKD occurrence (composite endpoint) increased by 48% compared to normal-TG subjects (adjusted OR:1.485, 95%CI 1.300-1.696; P<0.001). Moreover, each 50 mg/dL increase in TG levels resulted in significantly greater risk of eGFR reduction (OR:1.062, 95%CI 1.039-1.086 P<0.001) and ESKD (OR:1.174, 95%CI 1.070-1.289, P = 0.001).ConclusionsThis real-word analysis in a large cohort of individuals with low-to-moderate cardiovascular risk suggests that moderate-to-severe elevation of plasma TG levels is associated with a significantly increased risk of long-term kidney function deterioration.Copyright © 2023. Published by Elsevier B.V.

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