Volume : 2, Issue : 11, NOV 2016

DYSLIPIDEMIA AS A RISK FACTOR FOR RENAL CHRONIC FAILURE PATIENTS.

Mimoza Kuçi (Pisha), Tefta Rexha, M.Vasiu

Abstract

Patients with chronic renal failure present disorder in the level of lipoproteins which leads to increase risk of atherosclerosis. The objective of this study is to assess the risk of cardiovascular diseases in patients with chronic renal failure treated with dialysis, by performing a lipid profile measurement as: level of total cholesterol TC, triglycerides TG, “good” cholesterol HDL-ch, “bad” cholesterol LDL-ch, very low density lipoproteins VLDL and determining the risk factor based on the ratio of TC/HDL-ch and LDL-ch/HDL-ch. The sample consists in 45 patients treated with hemodialyses and 45 healthy subjects used as control group. The examination was performed in the biochemical laboratory of Elbasan hospital center for a spontaneous routine control of lipid profile. Blood samples for laboratory analyses were drawn after 12 hours of overnight fasting, and before the dialysis session for HD patients. Hemodialyses patients presented sinjificative (p< 0.05) differences with the results of lipid profile compared with control group. The results showed differences in the TG, LDL-ch and HDL-ch levels. Results were compared and was seen that hemodialyses group was characterized from high levels of triglycerides and low levels of HDL–ch. We conclude that, dyslipidemia which increases the risk of CVD by increasing atherogenezis, progresses over time in dialysis patients. The presence of two or more risk factor as: diabetes, smoking, contributes to the worsening of lipid profile.

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References

1. Bukachi F. et al., 2000. Lowering cholesterol in patients with coronary artery disease. African Health, 22 (2):16-18.

2. Coresh J, Longenecker JC et al., 1998. Epidemiology of cardiovascular risk factors in chronic renal disease. J Am Soc Nephrol 9: S24–S30.

3. Crook, E.D., Thallapureddy, A., Migdal, S. et al., 2003. Lipid abnormalities and renal disease: Is dyslipidemia a predictor of progression of renal disease?. Am J Med Sci. 325: 340–348.

4. Degoulet P, LeGrain M, et al., 1982. Mortality risk factors in patients treated by chronic hemodialysis. Report of the Diaphane collaborative study. Nephron 31: 103–110.

5. Durrington, 2003. “Dyslipidemia” Lancet 362(9385): 717-312 12957096.PMID

6. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) 2001. JAMA; 285:2486–97.

7. Fried L.F., Orchard T.J. and Kasiske B.L., 2001. Effect of lipid reduction on the progression of renal disease: a meta-analysis. Kidney Int, 260–2699.

8. Foley R.N, Parfrei P.S and Farnak M.J., 1998. Epidemiology of cardiovascular disease in chronic renal disease. J Am Soc Nephrol 9: S16–S23.

9. Go AS, Chertow G.M. et al., 2004. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351: 1296–1305.

10. Hadjadj S, Duly-Bouhanick B, Bekherraz A. et al., 2004. Serum triglycerides are a predictive factor for the development and the progression of renal and retinal complications in patients with type 1 diabetes. Diabetes Metab. 30: 43–51

11. Iseki K, Yamazato M, and Tozawa M.,2002. Hypocholesterolemia is a significant predictor of death in a cohort of chronic hemodialysis patients. Kidney Int. ;61:1887–93.

12. Joles, J.A., Kunter U., Janssen, U. et al., 2000. Early mechanisms of renal injury in hypercholesterolemic or hypertriglyceridemic rats. J Am Soc Nephrol. 11: 669–683.

13. Kasiske BL., 1998. Hyperlipidemia in patients with chronic renal disease. Am J Kidney Dis 32: S142–S156.

14. Kilpatrick RD, McAllister CJ, et al,. 2007. Association between serum lipids and survival in hemodialysis patients and impact of race. J Am Soc Nephrol. ;18:293–303.

15. Klahr S, Levey AS, Bech GJ, et al., 1994. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group. N Engl J Med.;330:877–84.

16. K. DOQI, 2003. Clinical practice guidelines for management of dyslipidemias in patients with kidney disease. Am J Kidney Dis. ;41:I–91.

17. Liu Y, Coresh J et al,. 2004. Association between cholesterol level and mortality in dialysis patients: role of inflammation and malnutrition. JAMA. ;291:451–9.

18. Lowrie EG and Lew NL,.1990. Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities.Am J Kidney Dis.;15:458–82.

19. Massy, Z.A., Khoa, T.N., Lacour, B. et al., 1994. Dyslipidemia and the progression of renal disease in chronic renal failure patients. Nephrol Dial Transplant.14: 2392–2397.

20. Massy, SA and Kasiske, BL. Hyperlipidaemia and management in renal disease. Nephrology, 1996; 16: 202-203.

21. McGill HCJ, McMahan CA., et al 1997. Effects of serum lipoproteins and smoking on atherosclerosis in young men and women: the PDAY Research Group: Pathobiological Determinants of Atherosclerosis in Youth. Arterioscler Thromb Vasc Biol.;17:95–106.

22. Prinsen BH, et al. Hypertriglyceridemia in patients with chronic renal failure: possible mechanisms. Kidney Int Suppl.;63:S121–4, 2003.

23. Rahman, M., W. Yang, S. Akkina, A., et al 2014. Relation of serum lipids and lipoproteins with progression of CKD: The CRIC study. Clin J Am Soc Nephrol 9: 1190-1198

24. Samuelsson, O., Mulec, H., Knight-Gibson, C. et al.,1997. Lipoprotein abnormalities are associated with increased rate of progression of human chronic renal insufficiency. Nephrol Dial Transplant.12:1908–1915.

25. Sarnak MJ,Foley RN., et al 2002. Cardiovascular disease risk factors in chronic renal insufficiency. Clin Nephrol 57: 327–335.

26. Sarnak MJ, et al,. 2003. 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 108: 2154–2169.

27. Schaeffner, E.S., Kurth, T., Curhan, G.C. et al., 2003. Cholesterol and the risk of renal dysfunction in apparently healthy men. J Am Soc Nephrol. 14: 2084–2091

28. Stefanovic, V. and Milojkovic, M., 2004. Treatment of dyslipidemia in chronic kidney disease. Int J Artif Organs. 27: 821–827