Dyslipidemia and anemia in chronically hemodialyzed patients

More than 50% of end-stage renal disease subjects treated by chronic hemodialysis die from cardiovascular events. Although there is some information regarding to anemia compensation and to the levels of biochemical risk factors of atherosclerosis in other countries, the data from the Czech Republic are missing. The aim of this study was to estimate mean cholesterol, triglyceride and hemoglobin levels in hemodialyzed subjects in the Czech Republic and to compare them with current guidelines. During the years 2001-2006, nephrologists of all subjects screened by duplex Doppler ultrasonography of our department were asked to fill in questionnaires with basic history and laboratory data. Hemoglobin concentration was calculated separately for years 2001-2004 and 2005-2006 because of the change of recommended target value from 105 to 110 g/l in 2004. A total of 258 subjects were included, aged 65 +/- 14 years, 93 of them males. Patients came from 46 different hemodialysis centers in the Czech Republic. The presence of hypertension and diabetes was in 72.5% and 39.5%, respectively. Only 13.2% of subjects had the smoking history, and another 10% currently smoked. The mean +/- SD laboratory results were as follows: total cholesterol 5.0 +/- 1.1 mmol/l, triglycerides (2.5 +/- 1.4 mmol/l). Hemoglobin concentration was 104.4 +/- 14.4 g/l (mean +/- SD) in years 2001-2004 and 110.1 +/- 16.2 g/l in years 2005-2006. Hemoglobin full blood concentration was lower than recommended 105 g/l in 55% of hemodialyzed subjects during years 2001-2004, and it was lower than 110 g/l during years 2005-2006 in 47% of patients. Hypercholesterolemia above recommended 5.17 mmol/l was present in 39% of subjects. Triglycerides were elevated above 1.69 mmol/l in 64% of patients. Only 10% of subjects were treated by lipid-lowering drugs. We can conclude that in the Czech Republic, patients treated by chronic hemodialysis frequently suffer from anemia, despite the growing evidence of erythrocyte stimulating agents treatment benefit. Similarly, considerable number of these subjects has hypercholesterolemia and hypertriglyceridemia, only rarely treated by lipid-lowering drugs. However, this therapy is still not adequately supported by clinical research evidence.