Dyslipidemia In Chronic Kidney Disease Research Articles

Stress-induced dyslipidemia in chronic kidney disease during the war: mechanisms, clinical consequences, piculiarities of correction. Review

Stress-induced dyslipidemia in chronic kidney disease during the war: mechanisms, clinical consequences, piculiarities of correction. Review

#1212 Trends in real-world lipid lowering therapy use among adult patients with chronic kidney disease: 5-year single center experience in the Philippines

Abstract Background and Aims Patients with chronic kidney disease (CKD) carry an extremely high burden for atherosclerotic cardiovascular disease (ASCVD), which worsens as CKD progresses. Several international guidelines, including the 2013 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, have recommended the use of lipid-lowering therapy (LLT) in this high-risk population. To evaluate the implementation of these recommendations in real-world practice, we assessed patterns of dyslipidemia management among patients with CKD. Specific objectives include describing the prevalence and intensity of LLT prescription [stratified by estimated glomerular filtration rate (GFR) and whether requiring renal replacement therapy or not] as well as adherence to guideline recommendations on LLT use. Method We conducted a single-center, cross-sectional study covering the period of January 2019 to December 2023. A review of inpatient and outpatient medical records of the Department of Medicine, University of the Philippine—Philippine General Hospital was done. Eligible patients were at least 18 years of age, and diagnosed with CKD. Exclusion criteria included having a concomitant diagnosis of Acute Kidney Injury, and being pregnant or breastfeeding at any point in the study period. Sociodemographic, clinical, and laboratory data were based off the latest entry in each patient's medical record. No clinical data were collected beyond those that were available on the records. Classification of statin intensity was based on the 2019 American Heart Association/American College of Cardiology Guidelines on the Management of Blood Cholesterol as well as the 2020 Philippine Clinical Practice Guidelines on the Management of Dyslipidemia. All analyses were descriptive and done using STATA 18. Categorical variables were summarized as frequencies and percentages. Continuous variables were reported as measures of central tendency [i.e. mean (SD) or median (IQR), as appropriate]. Results Of the 3845 patients included in the study, 2922 (76%) were prescribed LLT. The most common LLT were statins (92%), followed by statin/ezetimibe combinations (6%), then statin/fibrate combinations (2%). None were prescribed PCKS9 inhibitors, niacin, omega-3 fatty acids, or bile acid sequestrants. Among non-dialytic patients, the distribution of LLT use was as follows: a) eGFR ≥ 60 ml/min/1.73 m2: 40% (173/431) b) eGFR 30-60 ml/min/1.73 m2: 76% (1198/1576) c) eGFR <30 ml/min/1.73 m2: 84% (1551/1838). Among dialytic patients, 68% (601/884) were already on LLT prior to initiation of dialysis while 35% (283/884) were started on LLT after dialysis initiation. Notably, 89% (786/884) of these dialytic patients were still on moderate-to-high-intensity statin doses. Based on recommendations from the 2013 KDIGO guidelines, only 78% (2610/3334) of eligible patients were prescribed on LLT, while 61% (312/511) of ineligible patients were prescribed on LLT. Similar rates of adherence were seen to other international guideline recommendations on the management of dyslipidemia in CKD (e.g. 2018 American Heart Association/American College of Cardiology Guideline on the Management of Blood Cholesterol, 2019 European Society of Cardiology/European Atherosclerosis Society guidelines for the management of dyslipidaemias, 2020 Clinical Practice Guidelines for the management of dyslipidemia in the Philippines). Conclusion Real-world LLT use among CKD patients remains high, even at lower eGFRs. More importantly, a large proportion of patients remain under- and over-treated, highlighting significant gaps between guideline recommendations and real-world clinical practice. Further investigation regarding the underlying reasons for these practice variations is necessary to improve quality of care, and safely reduce the burden of dyslipidemia and ASCVD among CKD patients.

The Development of Dyslipidemia in Chronic Kidney Disease and Associated Cardiovascular Damage, and the Protective Effects of Curcuminoids

Chronic kidney disease (CKD) is a health problem that is constantly growing. This disease presents a diverse symptomatology that implies complex therapeutic management. One of its characteristic symptoms is dyslipidemia, which becomes a risk factor for developing cardiovascular diseases and increases the mortality of CKD patients. Various drugs, particularly those used for dyslipidemia, consumed in the course of CKD lead to side effects that delay the patient's recovery. Therefore, it is necessary to implement new therapies with natural compounds, such as curcuminoids (derived from the Curcuma longa plant), which can cushion the damage caused by the excessive use of medications. This manuscript aims to review the current evidence on the use of curcuminoids on dyslipidemia in CKD and CKD-induced cardiovascular disease (CVD). We first described oxidative stress, inflammation, fibrosis, and metabolic reprogramming as factors that induce dyslipidemia in CKD and their association with CVD development. We proposed the potential use of curcuminoids in CKD and their utilization in clinics to treat CKD-dyslipidemia.

Lipid profile of chronic kidney disease patients on two different modalities of treatment: Conservative versus hemodialysis

Background: Chronic kidney disease (CKD) is an irreversible deterioration of renal function and cardiovascular disease is the leading cause of mortality in CKD patients. Aims and Objectives: The aim of this study was to assess the pattern of lipid profile among cases of CKD. Materials and Methods: A cross-sectional study was conducted for 1 year covering total 200 cases (males and females) of newly diagnosed or known cases of CKD. Parameters recorded were as follows: Fasting blood sugar, Serum urea (S. Urea), Serum Creatinine (S. Creatinine), and lipid profile. Estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault formula. Results: Mean age was 51.04 years in conservative management patients and 53.20 years in hemodialysis patients. Overall, male-to-female ratio was 1.82:1. S. Creatinine, S. Urea, and eGFR were deranged more in patients on hemodialysis (Group 2). Mean values of low-density lipoprotein (LDL)-cholesterol, very low-density lipoproteins (VLDL), and serum triglycerides (TG) were significantly higher in patients on hemodialysis compared to those on conservative management, while mean high-density lipoprotein cholesterol was significantly lower. Dyslipidemia was more common in female CKD patients (P = 0.02). Conclusion: Dyslipidemia in CKD worsened as patients progressed to severe stages with significant increase in TG, LDL, and VLDL levels in hemodialysis cases in comparison to conservatively managed, confirming presence of atherogenic lipid profile needing early intervention to prevent cardiovascular complications.

Kidney Function and Lipid Levels in Older Adults: The Atherosclerosis Risk in Communities Study

Cardiovascular disease is a leading cause of mortality among older adults in the United States.1 Both chronic kidney disease (CKD) and dyslipidemia—important risk factors of cardiovascular disease—are common among older adults.2,3 Although there have been studies examining dyslipidemia in CKD among young and middle-aged adults, there is a paucity of literature on lipid levels by CKD stage in older adults.

Proteinuria-Lowering Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors in Chronic Kidney Disease Patients: A Real-World Multicentric Study.

Control of dyslipidemia in chronic kidney disease (CKD) is not always guaranteed with statins and/or ezetimibe. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) have opened up a new era in lipid control, but their effect on renal function and proteinuria in real life have not yet been evaluated. The aim of the present study was to analyze the evolution of renal function and proteinuria in a cohort of CKD patients treated with PCSK9i. This retrospective multicentric cohort study included CKD patients treated with PCSK9i. Baseline epidemiological data, comorbidities and laboratory findings (including estimated glomerular filtration rate [eGFR], proteinuria and lipid profile) were collected. The evolution of renal function, proteinuria and lipid profile was analyzed during the 1-year follow-up. The cohort included 76 patients (68% male, mean age 66 ± 10 years). The mean baseline creatinine was 1.55 ± 0.77 mg/dL, and the mean eGFR was 52 ± 22 mL/min/1.73 m2. Reductions in LDL-cholesterol, total cholesterol and triglycerides during the first month were 51 ± 25%, 32 ± 25% and 11 ± 40%, respectively, levels that remained stable throughout the first year (p < 0.001 for LDL-cholesterol and total cholesterol trends and p = 0.002 for triglyceride trend). During follow-up, proteinuria improved from 57 (9–481) to 30 (7–520) mg/g (p = 0.021). In addition, eGFR remained stable, and no adverse events were reported. In our cohort, dyslipidemia treatment with PCSK9i was associated with decreased proteinuria in CKD patients, an effect that might be due to reduced lipid nephrotoxicity. Clinical trials are needed to further investigate whether this impact on proteinuria can significantly slow CKD progression in the long term.

Dietary Lipids and Dyslipidemia in Chronic Kidney Disease.

The progression of chronic kidney disease (CKD) leads to altered lipid metabolism. CKD patients exhibit high blood triglyceride (TG) levels, reduced concentrations and functionality of high-density lipoproteins (HDL), and elevated levels of atherogenic small, dense, low-density lipoproteins (sdLDL). Disorders of lipid metabolism and other metabolic disturbances place CKD patients at high risk for cardiovascular disease (CVD). Extensive evidence supports the cardioprotective effects of unsaturated fatty acids, including their beneficial effect on serum cholesterol and TG levels. Dietary lipids might therefore be especially important in the nutritional management of CKD. We review current dietary recommendations for fat intake by CKD patients and suggest potential nutritional interventions by emphasizing dietary lipids that might improve the blood lipid profile and reduce cardiovascular risk in CKD.

Lipid Abnormalities Using Random Sampling In Patients With End Stage Renal Disease On Thrice Weekly Hemodialysis

Background: Cardiovascular disease (CVD) is the leading cause of death in the dialysis population. Among other risk factors abnormalities in lipid metabolism occur in patients with all stages of chronic kidney disease (CKD). The most common dyslipidemia in CKD and dialysis is hypertriglyceridemia, whereas the total cholesterol concentration can be normal or low, perhaps due in part to malnutrition. Although hypertriglyceridemia that occurs in CKD may not significantly increase coronary risk, other changes may contribute to the accelerated atherosclerosis. We tried to find out how many patients in our setup on thrice weekly hemodialysis are suffering from dyslipidemia and whether taking treatment or not.&#x0D; Methodology: Cross sectional study conducted at dialysis center of Sir Ganga Ram Hospital, Lahore including all seventy patients with ESRD undergoing regular HD three times a week, 4 hours per session. Random blood samples (Non-fasting) were collected before dialysis for lipid profile including serum&#x0D; triglyceride, LDL, HDL and total cholesterol.&#x0D; Results: Out of 70 patients only 3 (4.4%) patients were on statins for dyslipidemia. Triglycerides were high in 41.4%, total cholesterol was low in 61.4%, and HDL was low in 34.3%.&#x0D; Conclusion: Hypertriglyceridemia is major lipid abnormality among hemodialysis patients.

Oxidative stress increases 1-deoxysphingolipid levels in chronic kidney disease

Chronic kidney disease (CKD) leads to deep changes in lipid metabolism and obvious dyslipidemia. The dysregulation of lipid metabolism in turn results in CKD progression and the complications of cardiovascular diseases. To obtain a profound insight into the associated dyslipidemia in CKD, we performed lipidomic analysis to measure lipid metabolites in the serum from a rat 5/6 nephrectomy (5/6 Nx) model of CKD as well as in the serum from CKD patients. HK-2 cells were also used to examine oxidative stress-induced sphingolipid changes. Totally 182 lipid species were identified in 5/6 Nx rats. We found glycerolipids, total free fatty acids, and sphingolipids levels were significantly upregulated in 5/6 Nx rats. The atypical sphingolipids, 1-deoxysphingolipids, were significantly altered in both CKD animals and human CKD patients. The levels of 1-deoxysphingolipids directly relevant to the level of oxidative stress in vivo and in vitro. These results demonstrate that 1-deoxysphingolipid levels are increased in CKD and this increase directly correlates with increased kidney oxidative stress.

Management of dyslipidemia in chronic kidney disease

Dyslipidemia is one of the most important modifiable risk factors for cardiovascular morbidity and mortality in chronic kidney disease (CKD) patients. Lipid profile in CKD differs from that in general population. Even at normal or near-normal lipid levels, subparticles are more atherogenic and more pro-inflammatory. Because of altered clearance and metabolism of various lipid-lowering agents in CKD, its safety on long-term use remains a serious concern. Statins and ezetimibe remain drug of choice for most of the patients. The lowest and the safest dose of the drugs is guided by various trials. Until recently, not much study was available to formulate a guideline for these patients. However, recent studies and meta-analysis have solved this problem to some extent and that's evident with latest guidelines published by KDIGO and ACC/AHA.

Serum Lipoprotein(a) Level and Apolipoprotein B/A1 Ratio in Patients of Hemodialysis and Peritoneal Dialysis: A New Approach to Predict Cardiovascular Risks in Chronic Kidney Disease

Background: Serum lipoprotein(a) and Apolipoprotein B/A1 ratio are new, independent cardiovascular risk factors in patients on dialysis. Conversely, the choice of dialysis procedure influences the uremic dyslipidemia in chronic kidney disease (CKD) patients.&#x0D; Objective: To compare lipoprotein(a) levels and apolipoprotein B/A1 ratio in patients of chronic kidney disease (CKD) stage 5 undergoing hemodialysis or peritoneal dialysis.&#x0D; Methods: This cross-sectional study was conducted in Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from September 2016 to March 2018. A total of 55 CKD stage 5 patients were included in the study – 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Group A patients were on low flux dialysis with bicarbonate dialysate 4 hours twice weekly dialysis with unfractionated heparin as anti-coagulant with a dialysis adequacy (Kt/V) &gt;1.2. Group B patients were on 3 exchanges over 24 hours with 2 litres of 1.5% glucose fluid with a weekly measured Kt/V &gt;1.7. Serum levels of Lipoprotein(a), Apolipoprotein B/A1 ratio were measured in both groups by using the standard laboratory technique.&#x0D; Results: In group A, most of the patients were in 31-50 years age group (45.1%), while in group B, majority belonged to &gt;50 years age group (54.16%). Patients’ gender showed a male predominance in both groups, i.e. 54.83% and 70.83% respectively. Most of the patients were from urban areas, i.e. 87.1% and 70.8% group A and B respectively. Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B). Dyslipidemia was evident more in CAPD patients than HD patients, as per raised serum Lipoprotein(a) level (83.3% vs 74.1%) and raised Apolipoprotein B/A1 ratio (100% vs. 77.4%). Moreover, comparing with HD patients, CAPD patients showed increased level of serum Lipoprotein(a) (41.4±23.5 mg/dl vs 37.4±25.3 mg/dl; p&gt;0.05) and Apolipoprotein B/A1 ratio (1.59±0.24 vs 1.04±0.22; p&lt;0.001).&#x0D; Conclusion: The maintenance CAPD treatment is associated with more pronounced alterations of the lipoproteins and lipid metabolism than those observed during HD treatment. Besides, serum lipoprotein(a) level and apolipoprotein B/A1 ratio were found simple, accessible and effective markers of dyslipidemia in both groups.&#x0D; Bangladesh Crit Care J September 2020; 8(2): 91-95

COMPARATIVE STUDY OF LIPID PROFILE IN PATIENTS OF NON-DIABETIC CHRONIC KIDNEY DISEASE IN RELATION TO ITS SEVERITY

Objective: Chronic Kidney Disease (CKD) is a silent epidemic of the 21st century. Cardiovascular disease (CVD) is a major cause of morbidity and mortality among patients with CKD. This study aims to evaluate the type of dyslipidemia in CKD patients and correlates with the severity of renal dysfunction in CKD patients.&#x0D; Methods: The observational study was conducted in the Department of General Medicine, PRM MCH, Baripada between May 2018 and January 2019. 262 patients of CKD above 15 y of age, satisfying the inclusion and exclusion criteria were included in the study.&#x0D; Results: Out of 262 patients, 64.50% (169) were male and 35.50% (93) were females with M: F of 1.8:1. The age range was from 20 to 95. The average age of the patients in the study was 56.66+12.22 y. 45.04 % (118) of the patients were between 46 and 60 y of age. 68.70% of the patients had dyslipidemia. The comparison between lipid profiles of cases and controls showed a significant increase in total cholesterol, triglyceride, LDL and decrease in HDL.&#x0D; Conclusion: The prevalence of dyslipidemia in non-diabetic CKD is high. A high degree of abnormality is found in HDL with disease progression, which is statistically significant. Therefore, maintenance of desired lipid levels either through diet or early initiation of lipid-lowering drugs can be helpful in decreasing the risk of cardiovascular complications in CKD patients.

Study on Correlation of Carotid Artery Intima–Media Thickness and Dyslipidemia in Chronic Kidney Disease in a Bangladeshi Population

Background: In chronic kidney disease (CKD) patients,measuring carotid artery intima– media thickness (CIMT) canpredict coronary heart disease and stroke, resulting from systemic atherosclerosis.Objective: To find out correlation of carotid artery intima–media thickness and dyslipidemia in chronic kidney disease in a Bangladesh population.Methods: A cross-sectional analytic study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladeshi, between July 2014 and June 2015, on 80 CKD patients. Standard laboratory techniques were followed to estimate all biochemical parameters. CIMT measurement was done by duplex study of carotid vessels through high resolution B-mode ultrasound technique.Results: Among 80 patients, 29 (36%) were in 18-30 age group, 18 were (23%) 31-40 age group and 33 (41%) were between 41-50 age group; mean age was 36.1±9.5 years. 51 (64%) patients were male and 29 (36%) were female. Though mean CIMT was found markedly increased in all CKD patients, the differences among stage 3, 4 and 5 was not significant. Mean CIMT was found more in dyslipidemic patients in comparison those with normal lipid profile, which was statistically significant (p&lt;0.05). Positive correlations were found between total cholesterol (TC) and CIMT (r=+0.295; p=0.008), triglyceride (TG) and CIMT (r=+0.238; p=0.034), and lowdensity lipoprotein (LDL) and CIMT (r=+0.231; p=0.039). However, there was negative correlation between high-density lipoprotein (HDL) and CIMT (r=–0.242; p=0.030).Conclusion: Our data suggest that the mean carotid intima-media thickness was markedly high in patients with CKD in comparison to normal expected value; however, there was no significant difference in thickness among CKD stages 3, 4 and 5. It was also observed that carotid artery intima-media thickness showed significant positive correlation with total cholesterol, triglyceride and LDL, but negative correlation with HDL.International Journal of Human and Health Sciences Vol. 04 No. 04 October’20 Page : 271-276

Management of dyslipidaemia in patients with chronic kidney disease: a position paper endorsed by the Italian Society of Nephrology

Chronic kidney disease (CKD) represents a major public health issue worldwide and entails a high burden of cardiovascular events and mortality. Dyslipidaemia is common in patients with CKD and it is characterized by a highly atherogenic profile with relatively low levels of HDL-cholesterol and high levels of triglyceride and oxidized LDL-cholesterol. Overall, current literature indicates that lowering LDL-cholesterol is beneficial for preventing major atherosclerotic events in patients with CKD and in kidney transplant recipients while the evidence is less clear in patients on dialysis. Lipid lowering treatment is recommended in all patients with stage 3 CKD or worse, independently of baseline LDL-cholesterol levels. Statin and ezetimibe are the cornerstones in the management of dyslipidaemia in patients with CKD, however alternative and emerging lipid-lowering therapies may acquire a central role in near future. This position paper endorsed by the Italian Society of Nephrology aims at providing useful information on the topic of dyslipidaemia in CKD and at assisting decision making in the management of these patients.

Kidney-Secreted Erythropoietin Lowers Lipidemia via Activating JAK2-STAT5 Signaling in Adipose Tissue

Background: Dyslipidemia is commonly observed in various kidney diseases, renal specific secreted erythropoietin (EPO) may participate in this process. However, how this process is regulated has remained mostly elusive. Method: The dyslipidemia was evaluated in chronic kidney disease and ischemia kidney injury animal model. Primary cultured adipocytes was used to investigate the lipolytic effect of EPO. Lipidemia was evaluated in EPO treated animal. Blood samples from cardiac surgery-induced kidney injury were collected to assess correlationship between EPO and lipidemia. Findings: We found a decrease in secreted EPO, led to hypertriglyceridemia in chronic kidney disease (CKD) mice. In contrast, in ischemic kidney animal model, increased EPO triggered by hypoxia signaling activation, was accompanied by decreased triglyceride (TG) in plasma. Mechanistically, circulating EPO modulates JAK2-STAT5 signaling, which in turn enhances lipolysis in peripheral adipose tissue and contributes to dysregulated lipidemia in serum. Delivering of recombinant EPO into both normal and CKD mice suppressed plasma TG by accelerating lipolysis in adipose tissue. In a cohort of patients diagnosed with acute kidney injury after cardiopulmonary bypass surgery, the decreased TG and cholesterol negatively correlated with increased EPO in the serum. Interpretation: This study identifies that renal secreted EPO controls lipidemia in kidney disease, providing a new mechanism underlying dyslipidemia in chronic kidney disease. Circulating EPO stimulates lipolysis by targeting JAK2-STATA5 signaling in peripheral adipose tissue, providing new therapeutic target for dyslipidemia treatment. Funding Statement: This work was supported by grants from the National Natural Science Foundation of China (Nos. 81700640, 81970608). Declaration of Interests: The authors declare that there is no duality of interest associated with this manuscript. Ethics Approval Statement: All clinical study were approved by the Medical Ethics Committee of Nanfang Hospital (Guangzhou, China). The participants in the study provided written informed consent. All animal experiments were approved by the Institutional Animal Care Committee of Nanfang Hospital.

Dyslipidemia as a pathogenetic factor of the progression of the chronic kidney disease

The article presents current information on the pathogenetic role of lipid metabolism disorders and the value of lipotoxicity in renal pathology, contributing to the progression of nephropathy. The detected increase in cholesterol level, TAG, LDL, decrease in plasma HDL concentration in chronic kidney disease (CKD) is accompanied by significant changes in the composition of various lipoproteins caused by changes in the expression and activity of key proteins and enzymes involved in the biosynthesis, transport, remodeling and catabolism of lipids and lipoproteins. It has been proven that dyslipidemia in CKD affects the morphological and functional state of the kidneys, contributing to the development of renal lipotoxicity processes, affecting the structural and functional state of the kidneys, initiating oxidative stress, systemic inflammation, vascular damage, and dysregulation. To date, research on the significance of dyslipidemia as a pathogenetic factor in the formation of chronic kidney disease remains insufficiently studied. Dysregulation of lipid metabolism, leading to dyslipidemia, is often an undervalued complication of CKD.

Alterations of Fatty Acid Profile May Contribute to Dyslipidemia in Chronic Kidney Disease by Influencing Hepatocyte Metabolism.

Chronic kidney disease (CKD) is associated with atherogenic dyslipidemia. Our aim was firstly to investigate patterns of fatty acids (FA) composition through various stages of CKD, and secondly, to evaluate the effect of CKD-specific FA disturbances on the expression of genes related to lipid metabolism at a cellular level. Serum FA composition was analyzed in 191 patients with consecutive severity stages of CKD, and 30 healthy controls free from CKD. Next, HepG2 human hepatic cells were treated with major representatives of various FA groups, as well as with FA extracted from a mix of serums of controls and of CKD stage 5 patients. Across worsening stages of CKD severity, there was an increasing monounsaturated FA (MUFA) content. It was associated with a concomitant decrease in n-3 and n-6 polyunsaturated FA. The incubation of hepatocytes with FA from CKD patients (compared to that of healthy subjects), resulted in significantly higher mRNA levels of genes involved in FA synthesis (fatty acid synthase (FASN) increased 13.7 ± 3.5 times, stearoyl-CoA desaturase 1 (SCD1) increased 4.26 ± 0.36 times), and very low density lipoprotein (VLDL) formation (apolipoprotein B (ApoB) increased 7.35 ± 1.5 times, microsomal triacylglycerol transfer protein (MTTP) increased 2.74 ± 0.43 times). In conclusion, there were progressive alterations in serum FA composition of patients with CKD. These alterations may partly contribute to CKD hypertriglyceridemia by influencing hepatocyte expression of genes of lipid synthesis and release.

Android/gynecoid ratio as a prognostic factor for dyslipidemia in pediatric patients with chronic kidney disease

Background: there are multiple factors that increase the presence of dyslipidemia in chronic kidney disease (CKD). Objective: to determine if the android/gynecoid ratio (A/GR) has utility as a cardiometabolic factor for dyslipidemia in pediatric patients with chronic renal failure. Materials and methods: cohort study. Patients with terminal CKD in peritoneal dialysis and hemodialysis were included. Determinations of body composition, body mass index (BMI), and lipid profile were assessed for each patient. Subsequently, somatometry and lipid profile were performed at 6 and 12 months of follow-up. Statistical analysis: to identify the difference between the initial somatic and biochemical variables, and at 6 and 12 months, the Friedman test was applied. The Spearman coefficient determined the correlation of bodily and biochemical variables. Results: twenty-one patients were analyzed. Tryglycerides (TGL) serum at 12 months of follow-up increased significantly (6 vs 12 months, p = 0.05), without evidence of an increase in the Z score of the BMI (p = 0.98) or total cholesterol (p = 0.49). Body fat, fat percentage and Z score BMI did not correlate with changes in cholesterol and triglyceride levels at 6 and 12 months; however, the A/GI presented a statistically significant association with the change in serum concentrations of TGL at 6 (r = 0.65, p = 0.003) and 12 months of follow-up (r = 0.54, p = 0.02). Conclusions: the A/GI showed an association with the increase in the serum concentration of TGL at 12 months of follow-up.

Cardiovascular morbidity and dyslipidemia in chronic kidney disease: a cross-sectional study

Background: CKD is a risk factor for CVD and dyslipidemia is an important co-morbidity associated with both. CKD can lead to variations in lipid profile which can lead to atherosclerosis and thereby increase the risk for CVD.Objective was to analyse the clinical and diagnostic cardiovascular features of CKD patients and the associated variations in their lipid profile.Methods: This prospective study was conducted from May 2015 to May 2017 among 100 patients attending to Medicine department with documented biochemical and sonographic evidence of chronic kidney disease. The included participants were subjected to routine blood investigations including lipid profile and cardiovascular evaluation which included electrocardiography (ECG), chest X-ray and M-mode 2-Dimensional echocardiography. Data was recorded in a proforma and the results were analysed statistically.Results: The study included 100 patients with chronic kidney disease, majority (n=42, 42%) of them belonging to the 40-50 years age group. There was similar (p=0.78) representation of males and females in the study. Significantly (p=0.02) higher number (n=58) of alcoholics were present among the CKD patients. Significantly (p=0.04) higher proportion of patients with CKD had high TG (36%) and low HDL (30%) levels. Majority (58%) had CVD morbidity and Left ventricular hypertrophy was a characteristic feature in majority (n=15%) of the CKD patients as evaluated by ECG and ECHO.Conclusions: The study documented the association of CVD and dyslipidemia with CKD. It also revealed ECG and ECHO changes in CKD patients which can be useful predictors in determining the progression of the CVD complications in CKD.

Dyslipidemia in chronic kidney disease excluding diabetic and nephrotic aetiology

Background: Dyslipidemia is hypothesized as one of the risk factor of chronic kidney disease and plays an important role in the progression of renal failure. The present study was conducted to assess the association between ratio of TG/HDL-C and CKD and other abnormalities in the lipid profile in CKD patients.Methods: This case-control study was conducted in Government General Hospital from July 2013 to November 2013. 100 patients with CKD were included as study cases. 100 healthy patients from the same hospital, who came with different illness other than the study disease were included as controls. Fasting lipid profile was done – total cholesterol, triglycerides and high-density lipoproteins (HDL) were measured and low-density lipoproteins, &amp; TG/HDL ratio were calculated. Comparison of lipid parameters among study and control groups was done. P value &lt;0.05 was considered as statistically significant.Results: Majority of the study patients were under the age group of 40-50 years. Male dominance (86%) was seen in the study group. The association of HDL, LDL, TGL, TGL/HDL, TC parameters and stages of CKD was observed and found to be statistically significant (p value &lt;0.0001 and &lt;0.05). Comparison of lipid parameters among study and control groups were done and difference was found to be statistically significant (p value &lt;0.0001).Conclusions: Dyslipidemia should be treated in early stages of CKD to prevent secondary complications.