Association Between Dialysis Dose and Atherogenic Index of Plasma in Maintenance Hemodialysis Patients: The Role of Body Weight

This study aimed to evaluate the association between single-pool Kt/V (spKt/V) and the atherogenic index of plasma (AIP) in maintenance hemodialysis patients and to investigate the potential influence of body weight on this relationship. Sixty adult patients receiving maintenance hemodialysis were included in this single-center, cross-sectional study. AIP was calculated as log10[triglyceride/HDL cholesterol], using concentrations expressed in mmol/L. Associations between spKt/V and lipid parameters were assessed using Pearson and Spearman correlation analyses, and multivariable linear regression models were constructed with AIP as the dependent variable. The mean age was 59.6±14.8 years, 60.0% of patients were male, and 30.0% had diabetes mellitus. Mean spKt/V and AIP were 1.60±0.16 and 0.172±0.238, respectively. spKt/V was inversely correlated with AIP (Pearson r=-0.350, p=0.006; Spearman ρ=-0.285, p=0.027) and positively correlated with HDL cholesterol. No significant associations were observed with LDL cholesterol or total cholesterol. In unadjusted linear regression, higher spKt/V was associated with lower AIP (B=-0.507, p=0.006). The association was attenuated after adjustment for age, sex, and diabetes (B=-0.348, p=0.050) and became nonsignificant after further adjustment for body weight and hemodialysis vintage (B=-0.228, p=0.240). Higher spKt/V was associated with a more favorable triglyceride–HDL profile; however, this association was attenuated after adjustment for body weight and hemodialysis vintage, and an independent association with AIP was not demonstrated in the fully adjusted model. These findings suggest that body size may substantially influence the observed relationship between spKt/V and the atherogenic lipid phenotype.