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September 28, 2026Clinical Kidney JournalOpen Access

Remnant cholesterol and cardiovascular risk in maintenance haemodialysis

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Key result

Higher remnant cholesterol is linked to ~6% higher MACE risk per 10 mg/dL in hemodialysis.

  • HR 1.06
  • 95% CI 1.01-1.11
  • n=624

Why the study?

Data on the association of remnant cholesterol with cardiovascular and mortality outcomes in maintenance haemodialysis patients remain limited.

Population

624 maintenance haemodialysis patients from the RISCAVID cohort

Comparison

Higher versus lower remnant cholesterol levels

Design

Post-hoc analysis of a prospective cohort study

Follow-up

Median 31 months

Authors

DMDiego MoriconiUniversity of PisaMUMarco UlivelliUniversity of PisaACAdamasco CupistiUniversity of Pisa

Discussion

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Implication

Cohort study reveals increased cardiovascular risk from remnant cholesterol in maintenance haemodialysis, highlighting independent atherogenic risk.

Key Points

  • To determine whether remnant cholesterol is independently associated with major cardiovascular events and all-cause mortality in maintenance haemodialysis patients.
  • Conducted a post-hoc analysis of 624 maintenance haemodialysis patients followed for a median of 31 months in the prospective RISCAVID cohort.
  • Calculated remnant cholesterol as total cholesterol minus HDL-C minus directly measured LDL-C.
  • Evaluated primary 3-point major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke) and secondary all-cause mortality using multivariable Cox regression models.
  • Over a median 31-month follow-up, 328 patients experienced a 3-point MACE and 375 patients died.
  • Remnant cholesterol was independently associated with 3-point MACE (HR 1.06 per 10 mg/dL increase, 95% CI 1.01–1.11) after adjustment for traditional cardiovascular risk factors, LDL-C, statin therapy, and nutritional indices.
  • Restricted cubic spline analysis demonstrated a progressive linear increase in cardiovascular risk without a threshold effect, whereas remnant cholesterol was not significantly associated with all-cause mortality.

Study Design

Type

Cohort (n=624)

PICO

P
Population
624 maintenance haemodialysis patients from the prospective RISCAVID cohort, followed for a median of 31 months.
E
Exposure / Comparator
Remnant cholesterol
O
Primary Outcome
3-point major adverse cardiovascular events (MACE) — HR 1.06 (1.01-1.11)

Main Result

Hazard Ratio: 1.06 (95% CI 1.01–1.11)

Cite This Study

Moriconi et al. (2026) conducted a cohort in maintenance haemodialysis (n=624). Remnant cholesterol was evaluated on 3-point major adverse cardiovascular events (MACE) (HR 1.06, 95% CI 1.01-1.11). In maintenance haemodialysis patients, remnant cholesterol was independently associated with an increased risk of 3-point MACE (HR 1.06 per 10 mg/dL increase; 95% CI 1.01-1.11).

synapsesocial.com/papers/6ab9b5b87822ec8fc3d90ad7https://doi.org/10.1093/ckj/sfag337
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Associations between remnant cholesterol and cardiovascular events in patients undergoing dialysis: a nationwide cohort study2026
  2. 2Remnant cholesterol and risk of coronary heart disease beyond LDL-cholesterol and HDL-cholesterol: a population-based prospective cohort study2025
  3. 3High remnant-cholesterol levels increase the risk for end-stage renal disease: a nationwide, population-based, cohort study2024 · 8 citations
  4. 4Long-term prognostic impact of remnant cholesterol distribution after percutaneous coronary intervention and coronary artery bypass graft: insights from a nationwide cohort2025
  5. 5Remnant cholesterol and all-cause mortality risk: findings from the National Health and Nutrition Examination Survey, 2003-20152024 · 6 citations