{
  "abstract": "Background\n\nTraditional lipid markers have limited and inconsistent prognostic value in maintenance hemodialysis (MHD), a phenomenon often described as the lipid paradox. We evaluated whether lipid and apolipoprotein-related markers, particularly the ApoB/ApoA-I ratio, were associated with mortality in MHD patients.Methods\n\nThis single-center retrospective cohort study included 409 MHD patients. Lipid and apolipoprotein-related markers were analyzed as standardized continuous variables. Cox regression was used for all-cause mortality, and cause-specific Cox and Fine-Gray models were used for cardiovascular mortality.Results\n\nDuring a median follow-up of 55.7 months, 148 all-cause deaths occurred, including 61 cardiovascular deaths. ApoB/ApoA-I was not associated with all-cause mortality in the unadjusted model, but was independently associated with all-cause mortality in Model 3 (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.05-1.44; p = 0.012). The association was similar in sensitivity analyses. ApoB/ApoA-I was not significantly associated with cardiovascular mortality in exploratory Fine-Gray regression (subdistribution hazard ratio [SHR] 1.12, 95% CI 0.89-1.43; p = 0.337) and did not improve discrimination beyond the base clinical model.Conclusions\n\nThese findings suggest that ApoB/ApoA-I may contribute to risk characterization and etiologic understanding in MHD, but do not support its use as a stand-alone clinical prediction marker.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Zhongshan Hospital, Fudan University, No 180 Fenglin Road, Shanghai, China.",
    "Shanghai Key Laboratory of Kidney and Blood Purification, No 180 Fenglin Road, Shanghai, China.",
    "Department of Nephrology, Zhongshan Hospital, Fudan University, No 180 Fenglin Road, Shanghai, China. ding.xiaoqiang@zs-hospital.sh.cn.",
    "Shanghai Key Laboratory of Kidney and Blood Purification, No 180 Fenglin Road, Shanghai, China. ding.xiaoqiang@zs-hospital.sh.cn.",
    "Department of Nephrology, Zhongshan Hospital, Fudan University, No 180 Fenglin Road, Shanghai, China. shen.bo@zs-hospital.sh.cn.",
    "Shanghai Key Laboratory of Kidney and Blood Purification, No 180 Fenglin Road, Shanghai, China. shen.bo@zs-hospital.sh.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Zhen Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Fangfang Xiang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Wuhua Jiang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xuesen Cao"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Xiaoqiang Ding"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Bo Shen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7k0ee0wxy2shy.bib",
  "cited_by": 0,
  "doi": "10.1186/s12882-026-05224-1",
  "fulltext_url": "https://europepmc.org/articles/PMC13689163",
  "id": "7k0ee0wxy2shy",
  "issns": [
    "1471-2369"
  ],
  "landing_url": "https://europepmc.org/article/MED/42907969",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC870-923"
    ],
    [
      "openalex",
      "2727|Dialysis and Renal Disease Management"
    ]
  ],
  "openalex": "W7171181585",
  "pdf_url": "https://europepmc.org/articles/PMC13689163?pdf=render",
  "pmcid": "PMC13689163",
  "pmid": "42907969",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/7k0ee0wxy2shy.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42907969",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42907969"
    },
    {
      "first_seen": "2026-10-30T13:45:48Z",
      "native_id": "ca369a2858aa49b59f6791d8eb953496",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12882-026-05224-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Dialysis and Renal Disease Management",
      "subfield": "general"
    }
  ],
  "title": "ApoB/ApoA-I ratio and all-cause mortality in maintenance hemodialysis: a cohort study.",
  "title_text": "ApoB/ApoA-I ratio and all-cause mortality in maintenance hemodialysis: a cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:48Z",
  "url": "https://research.draconitic.com/paper/7k0ee0wxy2shy",
  "venue": "BMC nephrology",
  "versions": []
}