[Dyslipidemia in patients being treated with peritoneal dialysis]

Dyslipidemia endangers nephrological patients by its aterogenic effect as well as by the possibility of acceleration of renal damage progression. The aim of our work was: (1) To determine the influence of peritoneal dialysis (PD) with standard (glucose) dialysis solution on concentration of blood lipids and lipoproteins during 30 months of treatment. (2) To compare these results with a group of patients on hemodialysis (HD) and in pre-dialysis (in patients with plasmatic creatinine 250-400 micromol/l).

Concentrations of total cholesterol, LDL-cholesterol, HDL-cholesterol, non-HDL-cholesterol, triglycerides, lipoproteins(a), apolipoprotein A-1 and B, albumin, glucose, HbA1c and CRP were measured. We tested 24 patients on PD, 20 patients on HD and 20 patients in predialysis.

In patients on PD there was a statistically significant increase in total, non-HDL and LDL-cholesterol, lipoprotein(a) (p < 0.005), triglycerides (p < 0.05), and a decrease in HDL-cholesterol (p < 0.005), and we also observed a significant increase in CRP (p < 0.05) and in body mass index (p < 0.05) within 6 months. After 30 months of PD we detected a decrease in total cholesterol as well as in triglycerides to levels before the commencement of PD (p < 0.005). In patients on PD there were significantly higher values of non-HDL-cholesterol, LDL-cholesterol, lipoprotein(a), glucose, HbA(1c), CRP and BMI in comparison with the group of patients on hemodialysis and the patients in pre-dialysis (p < 0.05). HDL-cholesterol remained significantly low even after 30 months (p < 0.05).

Higher values of lipoprotein(a) and LDL-cholesterol, and decreased value of HDL-cholesterol in patients on peritoneal dialysis can have a negative influence on further prognosis of such patients as compared to patients on hemodialysis and those in pre-dialysis, and may contribute to a high risk for atherosclerosis in ESRD, especially in patients treated with CAPD.