Abstract
Introduction: Chronic kidney disease is in increasing trend due to increase inprevalence of Diabetes mellitus and Hypertension. Dyslipidemia is most common entity seen in chronic kidney disease patients and is responsible for Cardiovascular Disease (coronary artery disease). Hypertriglyceridemia is most common form of deranged lipid profile seen in them. So its utmost importance to identify dyslipidemia and treatment of the same to prevent morbidity and mortality related to it.
Methods: It is a case control study conducted in NSCB MCH JBP, MP after ethical committee clearance. Where, Subjects of 50 in number who are healthy people placed in Group-1, CKD patients who never underwent hemodialysis of 50 in number are in Group-2 and CKD patients who are on maintenance hemodialysis of 50 in number in Group-3. The baseline characteristics were noted and baseline investigations are done and after 12 hours of fasting, blood is collected for lipid profile, the values are tabulated and compared with each group.
Results: In our study we found that, there is increase in Tryglycerides (TG) in CKD patients with and without hemodialysis. The values are more consistent with increase in stages of CKD. TG values are more high in group 3 compared to group 2. Also TG values are higher in CKD patients with Diabetes Mellitus compared to CKD patients without DM. The values were statistically significant in each comparison(p-value <0.05). Along with Triglycerides(TG), Very Low Density Lipoprotein(VLDL), Low Density Lipoprotein(LDL) and Total Cholesterol increased in group 2 and 3 compare to group 1. High Density Lipoprotein (HDL) is decreased in group 2 and 3 compare to healthy patients.
Conclusion: Present study demonstrated that there is dyslipidemia with predominant hypertriglyceridemia in CKD patients irrespective of mode of management, but the derangement is much more common and significant in CKD with hemodialysis group and they are at high risk of cardiovascular disease. So one should consider to start lipid lowering drugs which decreases disease progression and dyslipidemia and its related morbidity and mortality.
Keywords: Chronic Kidney Disease (CKD), Hypertriglyceridemia, Hemodialysis, Cardiovascular disease.
References
- Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL et al: Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidneyin Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation 2003;108: 2154–2169.
- Kanbay M, Afsar B, Siriopol D, Unal HU, Karaman M, Saglam M, et al: Endostatin in chronic kidney disease: associations with in-flammation, vascular abnormalities, cardio-vascular events and survival. Eur J Intern Med 2016; 33: 81–87.
- 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: 1296–1305.
- Muntner P, He J, Astor BC et al. 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–
- Chawla V, Greene T, Beck GJ et al. Hyperlipidemia and long-termoutcomes in nondiabetic chronic kidney disease. Clin J Am Soc Nephrol 2010; 5: 1582–
- Dyslipidemia in patients with chronic renal failure and in renal transplant patients. B. Shah, S. Nair, RA Sirsat, TF Ashavaid, K. Nair Nephrology Section, PD Hinduja National Hospital's Research Centre, Mahim, Bombay.
- Emerging Risk Factors Collaboration, Di Angelantonio E, Sarwar N et al. Major lipids, apolipoproteins, and risk of vascular disease. JAMA 2009; 302: 1993–2000
- Friedwald WT, Levy RI, Friedrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma without the use of preparative ultracentrifuge. Clin Chem. 1992;22:1095-112.
- Kasper DL, Fauci A, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrisons Principles of Internal Medicine. 19th ed. USA: McGraw-Hill Education; 2015:1813.
- Summary of Recommendation Statements. Kidney Int Supplements. 2013;3:5-14.
- Gupta DK. Hypedipidemia in patents of chronic renal failure. Bombay Hospital J 1991; 33:45 50.
- Das BS, Mishra SK, Rao DVP. Serum lipids in chronic renal failure. J Assoc Physicians India 1984; 32:1019 1021.
- Kes P. Lipid abnormalities in CRF, nephritic syndrome and dialysis. Acta Med Crotica 2001; 55(4-5): 177-86.
- Cheung AK, Parker CJ, Ren K, Iverius PH. Increased lipase inhibition in uremia: I dentification of pre-beta HDL as a major inhibitor in normal and uremic plasma. Kidney Int 1996; 49 (5):1360-67
- shreenivasulu, S.N. Bhagyamma, R.Anuradha, Study of lipid profile in chronic renal failure patients undergoing heamodialkysis: A Hospital Based Study. J of evidence based medicine and health care.2015 Nov;2(45):8131-8135.
- Lokesh Rao Magar. S, Dr. Anwar Miya Mohammad, Dr. Sandhya Anil. S. A Study of Lipid Profile in Chronic Renal Failure Patients Undergoing Hemodialysis. IOSR Journal of Dental and Medical Sciences.2016 june;15(6):01-03.
- Hariom Sharma, Tejas J Shash, Jignesh et al Lipid profile and lipoprotein(a) in chronic renal failure patients with and without hemodialysis. International journal of medicine and public health.2012 oct-dec;2(4):28-31.
Corresponding Author
Dr Neelakanth U Parappanavar
Department of Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.146
