Dyslipidaemia in CKD Patients and Its Correlation With Severity of Renal Dysfunction

Abstract

BACKGROUND Chronic kidney disease (CKD) is a significant global health problem with significant morbidity and mortality. Dyslipidaemia along with an abnormal apolipoprotein profile and composition is a common complication associated with the decline in eGFR in CKD. The association between abnormal lipid profile and severity of CKD has rarely been studied in a general population, especially in Indian setup and may have a future prognostic and management implication in patients with CKD. Aims and Objectives-To study the pattern of lipid abnormalities in CKD patients and to correlate with severity of renal dysfunction. MATERIALS AND METHODSA descriptive comparative study was done using 50 cases of CKD of > 15 years age, along with 30 age and sex matched controls excluding confounding factors like diabetes, HTN, thyroid abnormalities, heart diseases, infection, inflammatory diseases, smoking, alcoholism etc. History, general and systemic examination, routine blood parameters, ECG, USG abdomen pelvis, serum total cholesterol, LDL, HDL, VLDL and triglycerides were done. The eGFR was calculated according to the CKD-EPI equation. Statistical analysis was done using student's t-test, ANOVA, Bonferroni test, Mann-Whitney U test, Chi-square test and Pearson's correlation. P value < 0.05 was considered as statistically significant. RESULTSThe lipid profile in cases were TC: 184.96 ± 24.85 mg/dL; TGL: 148.10 ± 32.71 mg/dL; HDL: 32.38 ± 5.78 mg/dL; LDL: 122.82 ± 24.76 mg/dL; VLDL: 29.68 ± 6.54 mg/dL. Correlation between eGFR shows a significant negative correlation with TC (p= 0.007), TGL (p= 0.002), LDL (p= 0.000) and VLDL (p= 0.002) and positive correlation with HDL (p= 0.000). Comparison of lipid profile with grades of eGFR shows significant association with TGL (f= 3.804, p= 0.004), HDL (f= 18.099, p= 0.000), LDL (f= 3.793, p=0.004) and VLDL (f= 3.631, p= 0.005), but not with TC (f= 2.194, p= 0.064). CONCLUSIONIn CKD depending on severity there is a rise in TC, TGL, LDL, VLDL and a fall in HDL depending on severity.

Comparative Study of Lipid Profile in Patients of Non-Diabetic Chronic Kidney Disease in Relation to Its Severity

“…On comparing various parameters between cases and controls, there is a significant rise in blood Urea (p<0.001**) and serum Creatinine (p<0.001**). Mohanty et al study also showed similar significant statistical association of total cholesterol (p= 0.001), triglyceride (p= 0.001), HDL (p= 0.000), LDL (p= 0.000) between control and cases [25]. Kumari et al study also found similar results to our study [32].…”

“…Mean age of cases was 56.66±12.22 y and control was 41.05±17.75 y. This was similar to that of CKD Registry of India 2007 [21] where the mean age of cases was 48.3±16.6 y and in the studies by Patel and Sirajwala et al [24] and by Mohanty et al [25].…”

“…These findings indicate a rise in serum total cholesterol, triglycerides, low-density lipoproteins and a fall in high-density lipoproteins in CKD with a fall in e-GFR. Similar changes in lipid profiles were seen by Ganta V et al [23], Patel and Sirajwala [24], Mohanty et al [25] and Machnur et al [34].…”