Key result
High small dense LDL-C is linked to ~15% higher risk of renal impairment progression.
Why the study?
Beyond LDL-C, sdLDL-C is a residual risk factor for atherosclerotic cardiovascular disease, but whether sdLDL-C levels can predict chronic kidney disease development remains unclear.
Does a high calculated small dense LDL-C level predict the progression of renal impairment in a general Japanese population?
Cohort (n=16,814)
No
Does a high calculated small dense LDL-C level predict the progression of renal impairment in a general Japanese population?
A high calculated small dense LDL-C level is an independent predictor for the progression of renal impairment regardless of LDL-C level, suggesting its utility in risk stratification for chronic kidney disease.
Answers are grounded in this paper and cite their sources.
Calculated sdLDL-C may flag higher CKD progression risk beyond LDL-C; hypothesis-generating and should not yet guide therapy.
BACKGROUND: Beyond low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C) is a residual risk factor for atherosclerotic cardiovascular disease. However, whether sdLDL-C levels can predict the development of chronic kidney disease remains unclear. METHODS AND RESULTS: or positive for urine protein. Cox proportional hazards model with a restricted cubic spline after adjustment for confounders showed a gradual increase in the hazard ratio (HR) for renal impairment with high levels of sdLDL-C. Compared with the L-sdLDL-C/L-LDL-C group (reference) the adjusted HRs for renal impairment were significantly higher in the H-sdLDL-C/H-LDL-C and H-sdLDL-C/L-LDL-C groups (1.13 [95% confidence interval 1.03-1.25] and 1.15 [95% confidence interval 1.03-1.29], respectively). The addition of a high sdLDL-C level (≥35.7 mg/dL) to traditional risk factors significantly improved the discriminatory capacity for renal impairment. CONCLUSIONS: A high calculated sdLDL-C level was an independent predictor for the progression of renal impairment regardless of LDL-C level in a general Japanese population.
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Aida et al. (2026) conducted a cohort in Renal impairment (n=16,814). High calculated small dense LDL-C (sdLDL-C) vs. Low sdLDL-C / Low LDL-C was evaluated on Progression of renal impairment (eGFR <60 mL/min/1.73 m2 or positive urine protein) (HR 1.15, 95% CI 1.03-1.29, p=0.015). High calculated small dense LDL-C levels were independently associated with an increased risk of renal impairment progression compared to low levels, even when LDL-C was low.
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