A study of fasting lipid profile in chronic kidney disease patients
DOI:
https://doi.org/10.18203/2320-6012.ijrms20192513Keywords:
Chronic kidney disease, Cardiovascular disease, Hemodialysis, Lipid profileAbstract
Background: Dyslipidemia is very much common in chronic kidney disease patients and is responsible for cardiovascular disease (CKD) which is most common cause of mortality in them. So, it is necessary to study the lipid profile in CKD patients to prevent morbidity and mortality.
Methods: Subjects each of 50 in number are grouped into healthy controls (group-1), CKD patients without hemodialysis (group-2), CKD patients with hemodialysis (group-3). After fasting of 12 hours, lipid profile is assessed in all cases.
Results: In this study, there is increase in Total cholesterol (TC), Low Density lipoprotein (LDL), very Low-Density lipoprotein (VLDL) and Triglycerides (TG) and decrease in High Density Lipoprotein (HDL) in all CKD patients compared to healthy controls (p-value for each parameter <0.001). There is increase in TC, TG and VLDL in diabetic CKD patients compare to non-diabetic CKD patients and p-value for each parameter is <0.05. It was found that TG and VLDL increase and HDL decrease in group-3 compare to group-2 is statistically significant (p-value for each <0.05) and no significant variation in TC and LDL in these groups.
Conclusions: Present study demonstrated that there is dyslipidemia in CKD patients irrespective of mode of management, but the derangement is much more common and significant in CKD with hemodialysis group and they are at risk of cardiovascular disease. It is better to start lipid lowering drugs which decreases disease progression and dyslipidemia.
References
Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American heart association councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Circulation. 2003;108:2154-69.
Whaley-Connell A, DeMarco VG, Lastra G, Manrique C, Nistala R, Cooper SA, et al. Insulin resistance, oxidative stress, and podocyte injury: role of rosuvastatin modulation of filtration barrier injury. Am J Nephrol. 2008;28(1):67-75.
Attman PO., Alauporic P. Lipid abnormalities in chronic renal insufficiency. Kidney Int. 1991;39(31):16-23.
Gokal R, Khanna R, Raymond T, Krediet, Nolph KD. Outcome in patients on continuous ambulatory peritoneal dialysis and hemodialysis. Lancet. 1987;14:1105-9.
Friedwald WT, Levy RI, Friedrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma without the use of preparative ultracentrifuge. Clin Chem. 1992;22:1095-112.
Kasper DL, Fauci A, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrisons Principles of Internal Medicine. 19th ed. USA: McGraw-Hill Education; 2015:1813.
Summary of Recommendation Statements. Kidney Int Supplements. 2013;3:5-14.
Hallan SI, Coresh J, Astor BC, Asberg A, Powe NR, Romundstad S. International comparison of the relationship of chronic kidney disease prevalence and ESRD risk. J Am Soc Nephrol. 2006;17:2275-84.
Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296-305.
Vaziri ND, Liang K, Parks JS. Down regulation of hepatic lecithin: cholesterol acyltransferase gene expression in chronic renal failure. Kid Int. 2001;59:2192-6.
Gupta DK. Hypedipidemia in patents of chronic renal failure. Bombay Hospital J. 1991;33:45-50.
Das BS, Mishra SK, Rao DVP. Serum lipids in chronic renal failure. J Assoc Physicians India. 1984;32:1019-21.
Kes P. Lipid abnormalities in CRF, nephritic syndrome and dialysis. Acta Med Crotica. 2001;55(4-5):177-86.
Chan MK, Varghese Z, Moorhead JF. Lipid abnormalities in uremia. Kidney Int. 1981;19:625.
Drueke T, Lacour B. Lipid metabolism. Massary and Glassocks Textbook of Nephrology. Baltimore, William and Wilkins; 1995.