Association between remnant cholesterol level and severity of chronic kidney disease in patients with type 2 diabetes

Studies on whether remnant cholesterol (RC) affects the progression of chronic kidney disease (CKD) remain insufficient. This study aimed to determine whether RC level was associated with the severity of CKD in patients with type 2 diabetes mellitus (T2DM). In total, 3383 individuals diagnosed with T2DM were enrolled in this cross-sectional study from China. The severity of CKD was defined as no, moderate, severe, and very severe CKD based on the urinary albumin-to-creatinine ratio and estimated glomerular filtration rate. Because RC was non-normally distributed, it was log-transformed and categorized into quantiles. Multivariate logistic regression and multivariate ordinal logistic regression analysis were performed to investigate whether RC was independently associated with CKD and its severity. The median RC level was 25.9 mg/dL. The number of patients with no, moderate, severe, and very severe CKD was 2587 (76.5 %), 520 (15.4 %), 189 (5.6 %), and 87 (2.5 %), respectively. After adjusting for confounding factors, the prevalence of CKD increased 1.67-fold when the log-transformed RC level was elevated by one unit (OR [95 % CI], 1.67 [1.43–1.95]). The likelihood of CKD severity increasing by one degree was 1.76-fold for each one-unit increase in log-transformed RC level (OR [95 % CI], 1.76 [1.52–2.05]). When RC was incorporated as a categorical variable, it still correlated with CKD severity compared with quantile 1 (Q1) (Q2, 1.30 [1.01–1.68]; Q3, 1.60 [1.23–2.07]; Q4, 2.39 [1.86–3.09]). The association remained regardless of whether the patient's traditional lipid profiles achieved the target range. RC level was associated with CKD severity even when traditional lipid profiles were within the target range in patients with T2DM.