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Lipid abnormalities in black renal patients
D E Burrell1, A Antignani, P Goldwasser
1Long Island College Hospital, Avram Center for Kidney Disease, Brooklyn, NY 11201.
Insights
Blacks generally exhibit better cardiovascular risk profiles than whites across various kidney disease stages, including lower total cholesterol and higher HDL-C. Longitudinal studies showed no significant impact of race on lipid profiles over time.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Biochemistry
Background:
- Racial disparities in lipoprotein (LP) and cardiovascular (CV) abnormalities are recognized in the general and dialysis populations.
- Limited research exists on race-LP-CV interactions within diverse renal disease groups.
Purpose of the Study:
- To investigate racial differences in lipid profiles and CV risk ratios across various chronic kidney disease (CKD) stages.
- To examine longitudinal changes in lipid profiles among end-stage renal disease (ESRD) patients and their relation to race.
Main Methods:
- Cross-sectional analysis of lipid profiles (total cholesterol, HDL-C, apo A-I, apo B) and risk ratios (TC/HDL-C, A-I/B) in patients with normal renal function, nephrotic syndrome, hemodialysis, peritoneal dialysis, post-transplant, and renal insufficiency.
- Longitudinal study of lipid profiles in ESRD patients over four yearly cross-sections, using ANOVA with covariate adjustment.
Main Results:
- Blacks generally showed a more favorable CV risk profile than whites, with lower total cholesterol, higher HDL-C, and better apo ratios across all renal disease groups.
- Whites had lower HDL-C and higher TC/HDL-C ratios than blacks in hemodialysis and CAPD populations.
- Longitudinal analysis revealed no significant effect of race on lipid profiles, though apo B decreased and A-I/B increased over two years.
Conclusions:
- Race is associated with distinct lipid profiles and cardiovascular risk factors across different stages of renal disease.
- While cross-sectional data suggest racial differences, longitudinal studies in ESRD patients did not demonstrate a significant impact of race on lipid profile changes over time.
Abstract:
Racial differences in lipoprotein (LP) and cardiovascular (CV) abnormalities have been noted in the general population and in the population of patients on dialysis. Few studies have investigated the interaction of race and LP and CV disturbances in other renal disease groups. We studied lipid profiles and risk ratios (total cholesterol (TC)/high density lipoprotein-cholesterol) (HDL-C) and apolipoprotein (apo) A-I/apo B (A-I/B)) and the influence of race across a spectrum of renal disease groups (normal renal function (NRD), nephrotic range proteinuria (NS), hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), post-transplant (TR), renal insufficiency (RI)). We also performed a longitudinal study of lipid profiles in patients with end stage renal disease (ESRD) and the relationship of these profiles to race and other variables. There was a general tendency towards a better CV risk profile for blacks than whites in all the groups. Blacks tended to have lower TC, higher HDL-C, lower TC/HDL-C, higher apo A-I, lower apo B, and higher A-I/B. We analyzed four yearly cross-sections of the HD and CAPD populations using ANOVA with adjustment for appropriate covariates. Whites had lower HDL-C and a higher TC/HDL-C risk ratio than blacks. HD patients had lower TC, TC/HDL-C, apo A-I, and apo B than CAPD patients, and women had higher TC than men. When lipid profiles were studied longitudinally by yearly intervals, no consistent significant changes were seen, but over two years, levels of apo B fell and A-I/B rose. Race had no significant effect on any of the longitudinal data.(ABSTRACT TRUNCATED AT 250 WORDS)