Increased serum concentration of apolipoprotein B is associated with an increased risk of reaching renal replacement therapy in patients with diabetic kidney disease.

Objective: Few studies have investigated the association of apolipoprotein B (ApoB) with the progression of diabetic kidney disease (DKD) and the risk of renal replacement therapy (RRT).Method: In this retrospective cohort study, a group of 258 DKD patients with stage 3-5chronic kidney disease(CKD)were divided into low ApoB (<1.1 g/L) and high ApoB (≥1.1 g/L) groups and followed-up for 20.51 ± 6.11 months. The association of the serum ApoB concentration with RRT was determined by Kaplan-Meier and Cox regression analysis. ApoB was measured in the serum.Results: Ninety-three of the 258 DKD patients needed RRT during follow-up. Kaplan-Meier analysis showed that patients with high ApoB were significantly more likely to progress to RRT than those with low ApoB (log-rank = 16.62, p < 0.001). The presence of high ApoB increased the risk of RRT. Analysis of ApoB as either a categorical (<1.1 g/L or ≥1.1 g/l) or continuous variable by univariate and multivariate regression found that ApoB was an independent risk factor of DKD progression to RRT in this group of DKD patients with stage 3-5 CKD (p < 0.05).Conclusion: Increased ApoB was an independent predictor of progression to RRT. A larger study is needed to confirm the unfavorable prognosis of increased ApoB in DKD patients.