HDL Cholesterol Concentration may Become One of the Predictors for Future Renal Dysfunction in JAPAN

Approximately 10% of the adult population worldwide is affected by chronic kidney disease (CKD) 1) .CKD has been shown to be a risk for the development of cardiovascular disease (CVD) and mortality.Therefore, it is important that conventional blood tests can detect prospective renal dysfunction early in the general population.Previous studies have shown that low high-density lipoprotein (HDL) cholesterol (-C) concentration is an independent prognostic marker for CVD 2) .Similarly, the J-LIT study showed an association between low HDL-C levels and high coronary artery disease events in Japan 3) .In addition to CVD, the large-scale studies in recent years revealed the association with HDL-C level and all-cause mortality in the world 4,5) .However, the relationship between the HDL-C levels and future renal dysfunction due to the lack of large population data in Japan is still unclear.The excellent study by Kosugi et al. 6) clarified, for the first time, and added new evidence that low HDL-C concentration is a predictor of future renal dysfunction in a large-scale general population in Japan.Especially, the real-world data from more than 760,000 participants, including Japanese citizens aged 40-74 years based on annual health examinations, are valuable for application to general medicine.Furthermore, this large-scale study has several implications.There are sex differences in the HDL-C concentration, with higher HDL levels in females 7) .Racial differences have also been reported in the estimation of CVD risk based on the HDL-C levels 8) .However, in this study, the HDL-C concentrations 40 mg/dL in both sexes were associated with adverse renal outcomes, despite apparent sex differences in the