Evolution of lipid profiles in long-term peritoneal dialysis

Serial lipid profiles of 102 patients starting chronic ambulatory peritoneal dialysis (CAPD) in our renal unit from January 1985 to December 1990 were collected retrospectively. Transient triglyceride elevation was noted during the first two years of CAPD but declined to normal levels even lower than those at baseline by 60 months. Total cholesterol, HDL and LDL cholesterol levels did not change significantly. Lipid-lowering agents were begun in 17 patients before initiating CAPD, 5 of whom achieved lipid profiles warranting cessation of therapy. Five other patients started treatment while on CAPD. No statistical difference in patient mortality was found when patients hyperlipidemic at the initiation of CAPD were compared to their normolipemic counterparts. We conclude that the return to normal plasma triglyceride levels after transient triglyceride elevation during long-term CAPD implies that adaptative mechanisms of triglyceride production in response to chronic glucose overload may ensue.