Lipid disturbances in chronic renal failure--patomechanisms and treatment

Lipid disturbances are a constant feature of chronic renal failure (CRF). They compose a significant risk factor for vascular complications, leading to increased morbidity and mortality in this patients group. The major lipid abnormality in the course of CRF is hypertriglyceridemia, but increased cholesterol level is also common. Numerous studies, including these from our Centre, point to the conclusion that hypertriglyceridemia is a consequence of both, increased TG production and impaired TG removal. In contrast hypercholesterolemia is mainly due to enhanced cholesterol biosynthesis. HMG-CoA reductase inhibitors (statins) compose the most promising group of drugs to treat lipid abnormalities in CRF. Apart from their lipid-lowering abilities they possess non-lipid, so called pleiotropic activities, which make them especially useful in proliferative and inflammatory kidney diseases.