Title: Lipid profile in Chronic Kidney Disease before and after hemodialysis
Authors: Dr Rupam Kumari, Dr Chakradhar Majhi, Dr L.K. Dash
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.21
Abstract
Introduction: cardiovascular complications were the major cause of mortality morbidity and mortality in hemodialysis patients.
Objective: To know the effect of hemodialysis on lipid profile in CKD patients.
Study Design: Hospital based observational study.
Study Setting: This study was done in department of general medicine VIMSAR,Burla, Odisha.
Study Duration: Nov 2016 to Oct 2018(24 Months).
Subjects and Methods: 100 patients of CKD on maintenance Hemodialysis were selected as study population diabetic Mellitus, liver disease and other causes of Dyslipidemia and metabolic were kept as exclusion criteria. Serum lipid profile was measured at the start of hemodialysis and subsequently after 6 months and 12 months of maintenance hemodialysis and those values were tabulated for comparison.
Results: In our study, serum triglyceride value after 6 months and 1 year after maintenance hemodialysis, was significantly elevated and serum HDL was significantly decreased as compared to those predialysis values.
Conclusion: Dyslipidemia is common in CKD Patients, Maintenance hemodialysis further deteriorates dyslipidemia in the form of further increase in serum triglyceride and decrease in HDL .This increase in risk of cardiovascular disease and further progression of CKD.
Keywords: Chronic kidney disease, dyslipidemia, lipid profile , HDL,hemodialysis.
References
- Himmelfarb J, Stenvinkel P, Ikizler TA, Hakim R. The elephant in uremia: Oxidant stress as an underlying concept of cardiovascular disease in uremia. Kidney Int. 2002;62: 1524–1538.
- Mc Cullough PA. Why is kidney disease the “spoiler” for cardiovascular outcomes? J Am Coll Cardiol. 2003;41:725–728.
- Stevinkel P, Alvestrand A. Inflammation in end-stage renal disease: Sources, consequences, and therapy. Semin Dial.2002;15:329–337.
- Samouilidou E, Grapsa E. Effect of dialysis on total antioxidant capacity and lipid peroxidation products in patients with endstage renal failure. Blood Purif. 2003;21:209–212.
- Shoji T, Ishimura E, Inaba M, Tabata T, Nishizawa Y. Atherogenic lipoproteins in end-stage renal disease. Am J Kidney Dis. 2001;38:S30–S33.
- Kaysen G. Lipid and lipoprotein metabolism in chronic kidney disease. J Ren Nutr. 2009;19:73–77.
- Liu J, Rosner MH. Lipid abnormalities associated with end- stage renal disease. Semin Dial. 2006;19:32–40.
- Go AS, 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.
- Muntner P, He J, Astor BC, Folsom AR, Coresh J. Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the Atherosclerosis Risk in Communities study.J Am Soc Nephrol 2005;16:529 –38.
- Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112–9.
- Agarwal SK, Srivastava RK. Chronic Kidney Disease in India: Challenges and Solutions. Nephron Clinical Practice. 2009; 111:c197-c203.
- Vaziri ND, Moradi H. Mechanisms of Dyslipidemia of chronic renal failure. Hemodialysis International. 2006; 10:1-7.
- Janicki K, Molas G, Furmaga J. Abnormal lipoprotein metabolism in hemodialysis patients, Annales Universitatis Mariae Curie – Sklodowska Lublin Polonia. 2007; 62:311-14.
- Shoji T, Nishizawa Y, Nishitani H, Yamakawa M, Morii H. Impaired metabolism of high density lipoprotein in uremic patients. Kidney Int 1992; 41: 1653-61.
- Huttunen JK, Pasternack A, Vanttinen T, Ehnholm C, Nikkila EA. Lipoprotein metabolism in patients with chronic uremia. Effect of hemodialysis on serum lipoproteins and postheparin plasma triglyceride lipases. Acta Med Scand 1978; 204: 211-8.