Markers of cholesterol synthesis to cholesterol absorption across the spectrum of non‐dialysis CKD: An observational study

In dialysis patients, cholesterol‐lowering therapy with statins is less effective than in other high‐risk patients. This may be explained by a shift from cholesterol synthesis toward cholesterol absorption. In line, markers of cholesterol absorption—such as campesterol—better predict atherosclerotic cardiovascular events than markers of cholesterol synthesis—such as lathosterol—in dialysis patients. To test the association between markers of cholesterol absorption such as campesterol—and markers of cholesterol synthesis—such as lathosterol—against cardiovascular events in non‐dialysis CKD patients. Altogether 251 patients those not on lipid‐lowering agents were followed annually for the composite endpoint atherosclerotic cardiovascular disease (ASCVD) and all‐cause death. During follow‐up of 5.2 ± 2.1 years, 61 participants reached the primary endpoint atherosclerotic cardiovascular disease/all‐cause death [ASCVD/D], 47 participants suffered from ASCVD, and 46 participants died. In univariate Cox regression analysis, campesterol/lathosterol ratio did not significantly predict ASCVD/D (HR 0.643; 0.358–1.155; 3rd vs. 1st tertile), all‐cause death (HR 1.309; 0.604–2.838; 3rd vs. 1st tertile) nor ASCVD (HR 0.589; 0.311–1.118; 3rd vs. 1st tertile). We did not observe a shift from cholesterol synthesis to cholesterol absorption across the spectrum of non‐dialysis CKD. Campesterol/lathosterol ratio did not predict future ASCVD or all‐cause death in non‐dialysis CKD.