Association of Serum Apolipoprotein B-Apolipoprotein A-I Ratio with Renal Function Decline in Patients with Chronic Kidney Disease

Open Access

Abstract

Background: Dyslipidemia is common in chronic kidney disease (CKD) and contributes to accelerated atherosclerosis and disease progression. The serum apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) ratio is an established marker of atherogenic risk; however, its role in predicting renal function decline in CKD patients remains inadequately explored, particularly in South Asian populations. Objective: To evaluate the association between serum ApoB/ApoA-I ratio and renal function decline in patients with chronic kidney disease. Methods & Materials: This prospective cohort study was conducted at Jalalabad Ragib-Rabeya Medical College, Sylhet, Bangladesh, from January 2023 to December 2024. A total of 80 CKD patients were enrolled using purposive sampling. Renal function decline was defined as a ≥25% reduction in eGFR or progression to a higher CKD stage during follow-up. Data were analyzed using SPSS version 23.0. Results: The mean age of participants was 52.6 ± 11.4 years, with a male predominance (62.5%). The mean ApoB/ApoA-I ratio was significantly higher in patients who experienced renal function decline compared to those who did not (p<0.001). The ApoB/ApoA-I ratio showed a significant negative correlation with eGFR (p<0.001). After adjustment for age, sex, diabetes, hypertension, and baseline eGFR, a higher ApoB/ApoA-I ratio remained an independent predictor of renal function decline (p=0.002). Conclusion: An elevated serum ApoB/ApoA-I ratio is independently associated with accelerated renal function decline in CKD patients. This ratio may serve as a simple and useful biomarker for risk stratification and early intervention in chronic kidney disease.