Lipid profile in pre-dialysis chronic kidney disease patients in southern Nigeria.

Oluseyi A Adejumo,Enajite I Okaka,Louis I Ojogwu

doi:10.4314/gmj.v50i1.7

Oluseyi A Adejumo, Enajite I Okaka + Show 1 more

Open Access

https://doi.org/10.4314/gmj.v50i1.7

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Abstract

Dyslipidaemia is one of the cardiovascular risk factors responsible for cardiovascular disease and rapid progression of chronic kidney disease (CKD) to end stage renal disease. Early detection and management of dyslipidaemia will reduce cardiovascular burden and retard progression of CKD. To determine the prevalence and pattern of dyslipidaemia in pre-dialysis CKD patients in a tertiary hospital in southern Nigeria. This was a case-control study that involved 105 consecutive pre-dialysis CKD patients recruited over two years and 105 age and sex matched control subjects. Data obtained from participants included demographics, body mass index, and aetiology of CKD. Blood sampling was done for the determination of creatinine and fasting serum lipids. P values < 0.05 were taken as significant. The mean age of the CKD and control subjects were 46.98±16.81 and 47.57±15.97 years respectively with a male:female ratio of 1.7:1. The median atherogenic index of plasma (AIP), low density lipoprotein-cholesterol and triglyceride (TG) were significantly higher in the CKD patients while mean high density lipoprotein-cholesterol (HDL-C) was significantly lower in the CKD patients (p=<0.001). The overall prevalence of dyslipidaemia in the CKD patients was 60% which was significantly higher than 39% in the control (p=0.002). The prevalence of high AIP, elevated TG and reduced HDL-C increased with worsening renal function. Dyslipidaemia was commoner in female CKD patients (p=0.02) and those who were ≥ 45years (p=0.94). Dyslipidaemia is common in pre-dialysis CKD especially in female and older patients. Some lipid abnormalities increased with worsening kidney function.

Highlights

Cardiovascular disease is the leading cause of hospitalization and mortality in patients with chronic kidney disease.[1]
To determine the prevalence and pattern of dyslipidaemia in pre-dialysis chronic kidney disease (CKD) patients in a tertiary hospital in southern Nigeria. This was a case-control study that involved 105 consecutive pre-dialysis CKD patients recruited over two years and 105 age and sex matched control subjects
The overall prevalence of dyslipidaemia in the CKD patients was 60% which was significantly higher than 39% in the control (p=0.002)

Summary

Introduction

Cardiovascular disease is the leading cause of hospitalization and mortality in patients with chronic kidney disease.[1] The process of cardiovascular disease most likely started in early stages of CKD considering its severity at commencement of renal replacement therapy (RRT).[2] Dyslipidaemia is one of the recognized traditional cardiovascular risk factors in the general population as well as CKD patients.[3,4] This cardiovascular risk factor occurs commonly in patients with CKD. Dyslipidaemia is associated with rapid decline in renal function and commencement of RRT in CKD patients.[8,9] The precise mechanism is unknown, but it has been postulated that mesangial cells bind and take up oxidized LDL which causes injury to mesangial, epithelial and endothelial cells by favouring recruitment of inflammatory cells such as macrophages which release cytokines, chemokines and growth factors.[10,11] This subsequently leads to glomerulosclerosis.[10] Hypercholesterolaemia and hypertriglyceridaemia cause podocyte injury and mesangial sclerosis, subsequently leading to glomerulosclerosis

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