High Remnant Cholesterol Levels may Worsen Kidney Function in Diabetic Patients: Study

A new study utilized data from the large-scale Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial revealed a significant association between elevated remnant cholesterol (remnant-C) and adverse renal outcomes in patients with Type 2 diabetes (T2DM). The findings published in the BMC Diabetology & Metabolic Syndrome journal suggest that this easily measurable lipid marker could play a major role in predicting kidney health deterioration in people living with diabetes.

The research analyzed data from a total of 10,196 participants over a 7-year follow-up period by focusing on 3 key renal outcomes which were the development of albuminuria, worsening renal function and progression to renal failure. Throughout the study period a total of 23.2% of participants (2,039 patients) developed albuminuria, 57.1% (5,824 patients) experienced worsening renal function and 2.7% (280 patients) progressed to renal failure.

After adjusting for multiple confounding factors this study found that higher levels of remnant-C were significantly associated with both the development of albuminuria (P = 0.007) and worsening renal function (P = 0.002). However, no significant link was found between remnant-C levels and the progression to renal failure (P = 0.621).

To ensure the reliability of their results, the team conducted sensitivity analyses, which consistently supported the association between elevated remnant-C and the risk of kidney complications in people with T2DM.

Chronic kidney disease is a common and serious complication of Type 2 diabetes which often leads to reduced quality of life and increased mortality. Identifying early risk factors like remnant-C could aid clinicians in earlier detection and better management of patients at risk for worsening renal health.

Remnant cholesterol which is a type of cholesterol-rich lipoprotein, is gaining attention for its role in cardiovascular and metabolic diseases. This findings add to the growing evidence that remnant-C may also be an important indicator of renal health. This study emphasize that remnant-C is an easily calculable and accessible measure that could provide valuable insights for healthcare professionals.

While the study did not find a connection between remnant-C and renal failure, the association with early-stage kidney dysfunction suggests that monitoring and managing remnant cholesterol levels could be a useful strategy in preventing more severe kidney damage. Overall, these findings may pave the way for further research into how targeted treatments addressing remnant cholesterol could reduce the risk of renal complications in patients with Type 2 diabetes.

Source:

Yu, P., Yuan, Q., Huang, L., Tao, L., Peng, Z., & Pu, J. (2025). The prognostic value of remnant cholesterol to adverse renal outcomes in patients with type 2 diabetes. Diabetology & Metabolic Syndrome, 17(1). https://doi.org/10.1186/s13098-025-01617-8