Lipid disorders, statins and the peritoneal membrane

Lipid disturbances are common in patients with chronic renal failure and peritoneal dialysis (PD) patients have in general an even more atherogenic lipid profile. The pathogenesis of the lipid profile in PD patients is not well understood, but both the peritoneal protein loss and the glucose absorption from the dialysate may contributes to these alterations. Hydroxymethylglutaryl coenzyme A reductase inhibitors, more commonly known as statins, are effective to reduce low density cholesterol levels in PD patients, but so far no large studies has been performed concerning the effects on clinical outcome in PD patients. Except from the lipid lowering effects, statins also have pleiotropic effects that are independent of their lipid lowering effect. Several of these pleiotropic effects may inhibit pathogenetic pathways involved in the long-term structural and functional changes in the peritoneal membrane, which also is supported by limited data from animal studies. Further studies in PD patients are needed concerning the potentially beneficial effects of statins on the peritoneal membrane.