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Dyslipidemia in chronic kidney disease: an approach to pathogenesis and treatment

Vasilis Tsimihodimos1, Evangelia Dounousi, Kostas C Siamopoulos

  • 1Department of Nephrology, Medical School, University of Ioannina, Ioannina, Greece.

American Journal of Nephrology
|July 10, 2008
PubMed

Insights

Cardiovascular disease (CVD) risk is high in chronic kidney disease (CKD). Statins may benefit mild to moderate CKD patients, but lipid-lowering therapy for end-stage renal disease (ESRD) requires individualization.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Pharmacology

Background:

  • Cardiovascular disease (CVD) is a leading cause of death in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD).
  • Dyslipidemia, a significant risk factor for CVD in the general population, is prevalent in CKD patients due to altered lipoprotein metabolism.
  • Renal dyslipidemia contributes to the high CVD burden in CKD patients.

Purpose of the Study:

  • To review the pathogenesis and treatment of dyslipidemia in patients with CKD.
  • To analyze lipid abnormalities across various stages of CKD and renal replacement therapies.
  • To evaluate the impact of epoietin and hypolipidemic drugs on lipid profiles in CKD.

Main Methods:

  • Analysis of studies on lipid abnormalities in CKD stages 1-4, nephrotic syndrome, hemodialysis, and peritoneal dialysis patients.
  • Review of lipid profiles in kidney graft recipients.
  • Examination of epoietin and hypolipidemic drug effects in CKD patients.

Main Results:

  • Lipoprotein metabolism disturbances are present early in CKD and worsen with declining renal function.
  • Phenotypic expression of lipid alterations is influenced by intrinsic and exogenous factors.
  • Mild to moderate CKD patients, unlike dialysis patients, may benefit from statin therapy.

Conclusions:

  • Statin therapy is recommended for patients with mild to moderate CKD.
  • Lipid-lowering treatment strategies for ESRD patients should be individualized.
Abstract

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