Abstract
Background: Patients with chronic kidney disease (CKD) are prone to develop diseases related to the cardiovascular system owing to the accelerated rate of atherosclerosis due to a multitude of factors, one of them being the characteristic "atherogenic" lipid profile abnormality that they exhibit.
Aims and Objectives: To study the pattern and correlation between lipid profile and staging in non-diabetic Chronic Kidney Disease patients.
Materials and Methods: A total 100 CKD patients (Case group) were studied and compared with 100 age and sex matched healthy subjects (Control Group) in the Department of Medicine, G.R. Medical College and J.A. Group of Hospitals, Gwalior between February 2014 to November 2015. Detailed history followed by blood urea, serum creatinine, serum albumin, albumin to creatinine Ratio (ACR), albumin excretion ratio (AER) was recorded. Plasma lipids concentration was also measured after a 12-h overnight fast.
Results: Male preponderance (56%) was observed. Value of triglyceride (166.3±51.8 vs. 109.9±26.86; p<0.0001 respectively) and VLDL (31.2±12.32 vs. 23.01±5.46; p<0.0001 respectively) were increased in cases as compared to control. HDL (30.44±7.06 vs. 46.98±10.67; p<0.0001 respectively) was lower in cases in comparison to controls. Comparing lipid profile with GFR categories showed that TG, LDL and VLDL were progressively increasing with successive categories while HDL value was progressively decreasing. TG, HDL, LDL and VLDL value were more deranged in A3 category in comparison to A2 while cholesterol value was rather decreased in A3(p >0.05). Negative correlation was obtained between GFR and triglycerides (r=-0.543, p=0.001), total cholesterol (r=-0.275, p=0.001), LDL (r=-0.427, p=0.001) and VLDL (r=-0.476, p=0.001) while positive correlation was recorded with HDL (r=0.268, p=0.001).
Conclusion: The high prevalence of lipid abnormalities in CKD may accelerate the progression of CVD and increase the mortality of patients. Hence it is important to test and detect patients at high risk early on and manage accordingly.
Keywords: Lipid abnormality, chronic kidney disease, non-diabetic CKD.
References
- Paul JK, Kurian S. Study of Lipid Profile in Chronic Kidney Disease Patients of Non Diabetic Etiology and its Relation to Serum Calcium . JMSCR 2017;5 (9): 28284-90.
- Abrass CK. Cellular lipid metabolism and the role of lipids in progressive renal disease.Am J Nephrol. 2004 JanFeb;24(l):46-53.
- Solakivi T, Jaakkola O, Salomaki A, Peltonen N, Metso S, Lehtimaki T, Nikkari ST. HDL enhances oxidation of LDL in vitro in both men and women.Lipids Health Dis. 2005 Oct 20;4:25.
- Centre for Disease Control and Prevention (CDC). National chronic kidney disease fact sheet 2014. CDC, Atlanta, United States of America. 2014. Accessed at: www.cdc.gov/diabetes/pubs/pdf/kidney_factsheet.pdf Accessed on 13 April 2018.
- Kayima JK, Otieno LS, Gitau W, Mwai S. Thyroid hormone profiles in patients with chronic renal failure on conservative management and regular haemodialysis. East Afr Med J 1992 Jun;69(6):333‑6.
- Avasthi G, Malhotra M, Narang A, Sengupta S. Study of thyroid function test in patients of chronic renal failure. Indian J Nephrol 2001; 11:165‑9.
- Rajapurkar MM, John TJ, Kriplani AL. What do we know about chronic kidney disease in India: first report of the Indian CKD registry.BMC Nephrol 2012;13:10.
- Lim VS, Fang VS, Katz AI et al. Thyroid dysfunction in chronic renal failure. A study of the pituitary-thyroid axis and peripheral turnover kinetics of thyroxine and triiodothyronine. J Clin Invest. 1977;60(3):522-34.
- Attman PO, Alaupovic P. Lipid abnormalities in chronic renal insufficiency. Kidney Int Suppl. 1991 Apr;39:S16-S23.
- Mohanraj P, Anbazhagan G, Kalaivalli S. Evaluation of Lipid Profile in Non-Diabetic Chronic Kidney Disease Stage 3 and 4. J Evidence Based Med Healthcare. 2014 Aug;1(6):338-46.
- Chan MK, Persaud J, Varghese Z, Moorhead JF. Pathogenic roles of post heparin lipases in lipid abnormalities in hemodialysis patients. Kidney Int. 1984 May;25(5):812-8.
- Mordasini R, Frey F, Flury W, Klose G, Greten H. Selective deficiency of hepatic triglyceride lipase in uremic patients. N Engl J Med. 1977 Dec 22;297(25):1362-6.
- Appel G. Lipid abnormalities in renal disease. Kidney Int. 1991 Jan;39(1):169-83.
- Shah B, Nair S, Sirsat RA, Ashavaid TF, Nair KG. Dyslipidemia in patients with chronic renal failure and renal transplant patients. J Postgrad Med. 1994 Apr-Jun;40(2):52-4.
- Goldberg AP, Appletaum-Bondan DM, Bierman EL, Hazzard WR, Haas LB, Sherrard DJ, et al. Increase lipoprotein lipase during Clofibrate treatment of hypertriglyceridemia in patients on hemodialysis. New Eng J Med. 1979; 301: 1073-6.
- Fuh MM, Lee CM, Jeng CY, Shen DC, Shieh SM, ReavenGm et al. Effect of CRF on HDL kinetics. Kidney Int. 1990 May;37(5):1295-300.
- Rapport J, Aviram M. Defective high density lipoprotein composition in patients on chronic hemodialysis. New Eng J Med. 1978;299:1326-9.
- Saroj K, Rajendra KC, Sharad G. Thyroid dysfunction and dyslipidemia in chronic kidney disease patients. EndocrDisord. 2015;15:65.
- Poudel B, Yadav BK, Jha B, Raut KB. Dyslipidemia in chronic kidney disease in Nepalese population. Mymensingh Med J. 2013;22(1):157-63.
- Cheung AK, Wu LL, Kablitz C, Leypoldt JK. Atherogenic lipids and lipoproteins in hemodialysis patients. Am J Kidney Dis. 1993 Aug;22(2):271.
- Sharon A, Garcia DL,Brenner BM. Renal and systemic manifestations and glomerular disease. In: Text book of Kidney, Vol.2, Edn.4, W.B. Saunders Company, Philadelphia. 1991: pp1852-60.
- Ganta V, Yalamanchi RP, Mahanta KC, Sahu B, Kota R, Gudipati A, Bharadwaj B, Reddy CR. A study of lipid profile in non-diabetic chronic kidney disease. Int J Adv Med 2016;3:965-70.
Corresponding Author
Dr Anvesh Singh Parmar
Department of Medicine, GR Medical College, Gwalior, MP India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mob: 7987430419
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.162
