Association between serum lactate dehydrogenase level and renal outcome in patients with advanced chronic kidney disease without diabetes mellitus

Background Higher serum lactate dehydrogenase (LDH) levels are associated with poor prognosis including renal outcome, all-cause and cardiovascular mortality in patients with diabetic kidney disease. However, this association remains unclear in patients with chronic kidney disease (CKD) without diabetes mellitus (DM). Methods Using data from the PREDICT trial, which enrolled patients aged 20–85 years with an estimated glomerular filtration rate (eGFR) of 8–20 mL/min/1.73 m 2 and hemoglobin <10 g/dL due to renal anemia without DM, we investigated the association between serum LDH levels and study outcomes. Results In total, 444 patients (median age, 73 years; 61% men; mean eGFR, 13.5 mL/min/1.73 m 2 ) were divided into four quartiles according to serum LDH level: Q1, 78–169 U/L; Q2, 170–193 U/L; Q3, 194–224 U/L; Q4, 225–503 U/L. The median observation period for renal composite events and the composite of cardiovascular events or death were 562 and 637 days, respectively. In total, 206 (46%) patients experienced renal composite outcomes, and 45 (10%) patients experienced a composite of cardiovascular events or death. The multivariable analysis showed that the Q4 group had a higher risk of renal composite outcomes (adjusted hazard ratio [aHR], 2.07; 95% confidence interval [CI], 1.39–3.08) and the composite of cardiovascular events or death (aHR, 2.77; 95%CI, 1.21–6.32) compared with the Q1 group. Conclusions Higher LDH levels are associated with higher risk of renal complications and composite of cardiovascular events or death in patients with advanced CKD without DM.