Elevated Non-Fasting Remnant Cholesterol Predicts All-Cause Mortality in Hemodialysis Patients.

INTRODUCTION: Remnant cholesterol (RC) has been proposed as a mortality indicator in various populations; however, it remains unknown whether non-fasting RC can predict prognosis in patients undergoing hemodialysis (HD). METHODS: This retrospective study enrolled 203 patients who underwent regular HD between May 2023 and May 2026. Patients were divided into four groups according to quartiles of non-fasting RC. RESULTS: Cox proportional hazards models revealed that RC was an independent predictor of all-cause mortality (hazard ratio [HR], 2.25; 95% confidence interval [CI], 1.10-4.62). In a joint analysis using upper quartile cut-offs of RC and low-density lipoprotein cholesterol (LDL-C), the high RC/high LDL-C group had a significantly higher mortality risk (HR: 2.67; 95% CI: 1.51-4.76) compared with the reference group. Isolated elevation of either RC or LDL-C was not associated with an increased mortality risk. CONCLUSIONS: RC may be a useful predictor of all-cause mortality in patients undergoing HD.