A study of lipid profile in maintenance hemodialysis patients

Abstract

With increasing prevalence of Chronic Kidney Disease (CKD), CKD related cardiovascular diseases (CVD), end stage renal disease (ESRD) and the consequent financial burden of renal replacement therapy (RRT), the importance of CKD and its risk factors needs to be considered. Hence, lipid profile was studied in maintenance hemodialysis (MHD) subjects.An observational study consisting 100 patients diagnosed as ESRD on MHD of age group 18-70 years of both sex were selected from Nephrology unit, KIMS, Hubballi. Serum lipid profile was estimated by enzymatic method, urea by GLDH- Urease method, serum creatinine by Jaffe’s method.A significant patients had low serum lipid levels with mean ± standard deviation of Total cholesterol (mg/dl) 131.93±49.75, Triacylglyceride (mg/dl) 107.53±52.36, HDL-C (mg/dl) 28.93±10.06 & LDL-C (mg/dl) 82.23±42.89 and serum creatinine (mg/dl) 8.28± 2.45 & Blood urea (mg/dl) 110.51± 37.58 ESRD patients are at higher risk and it is expected to have serum lipids as per NCEP-ATP-III guidelines. In contrast to this, where these levels are associated with increased risk of CVD, decrease values in dialysis patients are strongly correlated with increased morbidity including a higher risk of cardiovascular events and death. This observation is referred as “reverse epidemiology/risk factor–paradox”. It may be due to superimposed factors like inflammation and/or malnutrition that lead to lower cholesterol levels. In addition, chronic renal failure per se, primarily affects the metabolism of HDL-C and Triacylglyceride rich lipoproteins. Despite conflicting reports, hypercholesterolemia paradoxically appears to be associated with more favorable outcome in ESRD patients.