Association of blood urea nitrogen to high-density lipoprotein ratio with all-cause and cardiovascular mortality in individuals with mildly reduced eGFR.

Shijia Jin, Yilin He, Yifan Zhang, Zhong Chen

Abstract read

In one paragraph

Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Shijia JinDepartment of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Yilin HeDepartment of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Yifan ZhangDepartment of Critical Care Unit, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Zhong ChenDepartment of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: zhongchen7498@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with mild-to-moderate renal impairment face elevated cardiovascular risk, yet early detection tools remain limited. The Cardiovascular-Kidney-Metabolism (CKM) interplay underscores the need for integrated biomarkers. The Blood Urea Nitrogen (BUN) to High-Density Lipoprotein (HDL) cholesterol ratio (BUN/HDL) was therefore evaluated for early risk stratification.

methodsThis cohort study included National Health and Nutrition Examination Survey (NHANES) participants (2007‒2018) with mildly reduced estimated Glomerular Filtration Rate ([eGFR] < 90 mL/min/1.73 m

resultsElevated BUN/HDL showed a modest association with all-cause (HR = 1.050, 95% CI: 1.021-1.081) and cardiovascular mortality (HR = 1.062, 95% CI: 1.020‒1.105). Optimal cut-points were 6.41 (AUC = 0.650) for all-cause and 5.00 (AUC = 0.682) for cardiovascular mortality. Subgroup analyses suggested a stage-dependent pattern. For all-cause mortality, associations were consistent in Chronic Kidney Disease (CKD) stage G2 (HR = 1.079, p = 0.002) and G3 (HR = 1.058, p = 0.025). For cardiovascular mortality, the association was significant in CKD stage G2 (HR = 1.127, p < 0.001). This cardiovascular association was stronger in non-hypertensive individuals. Machine learning confirmed BUN/HDL as a robust predictor within NHANES dataset, with final models showing excellent discrimination (AUCs 0.820-0.837) and calibration.

conclusionThe BUN/HDL ratio demonstrates a consistent, albeit modest, association with mid-term mortality, providing preliminary support as a CKM risk indicator among individuals with mildly reduced eGFR.

Indexed as

Blood urea nitrogenHigh-density lipoprotein cholesterolMildly reduced eGFRMortalityNational health and nutrition examination survey (NHANES)

Identifiers

PMID42700547

DOI10.1016/j.clinsp.2026.101096

PMCPMC13579277

What Socratic holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.