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Effect of lifestyle changes and atorvastatin administration on dyslipidemia in hemodialysis patients: a prospective
Insights
Lifestyle changes partially improve dyslipidemia in hemodialysis patients. Atorvastatin effectively treats remaining dyslipidemia in about 60% of non-responders, impacting key biomarkers.
Area of Science:
- Nephrology and Cardiovascular Research
- Lipid Metabolism and Atherosclerosis
- Pharmacological Interventions in Chronic Disease
Background:
- Atherogenic dyslipidemia is a significant risk factor for cardiovascular complications and mortality in hemodialysis (HD) patients.
- Effective management of dyslipidemia is crucial for improving outcomes in this vulnerable population.
Purpose of the Study:
- To evaluate the combined effects of lifestyle modifications and subsequent atorvastatin treatment on dyslipidemia in HD patients.
- To assess the impact of these interventions on specific lipid profiles and biomarkers.
Main Methods:
- Prospective study involving 49 dyslipidemic HD patients.
- Initial 21-week lifestyle intervention followed by 14 weeks of atorvastatin treatment (10-20 mg/d) in non-responders.
- Monitoring of lipid levels, salusin α, oxidized LDL, fructosamine, and monocyte CD36 expression.
Main Results:
- Lifestyle changes led to significant improvements in HDL cholesterol, LDL cholesterol, salusin α, oxidized LDL, fructosamine, and CD36 expression.
- Atorvastatin treatment in non-responders resulted in significant reductions in LDL cholesterol and triglycerides, with dyslipidemia resolution in 59.4% of patients.
- Interventions modulated plasma salusin α and monocyte CD36 expression.
Conclusions:
- Lifestyle interventions offer selective benefits for dyslipidemia in HD patients.
- Atorvastatin (up to 20 mg/d) is effective in approximately 60% of HD patients who do not respond adequately to lifestyle changes.
- Lipid-lowering therapies influence key biomarkers like plasma salusin α and monocyte CD36 expression.
Introduction:
Atherogenic dyslipidemia accelerates the development of cardiovascular complications and contributes to mortality of hemodialysis (HD) patients.
Objectives:
The aim of the study was to evaluate the effects of lifestyle changes followed by treatment with atorvastatin in dyslipidemic HD patients.
Patients And Methods:
Dyslipidemic HD patients (n = 49) were enrolled into the prospective study. Forty-two patients completed a 21-week lifestyle intervention. In 34 patients, who continued to be dyslipidemic, atorvastatin was used for 14 weeks. After 4 weeks, the initial dose of atorvastatin of 10 mg/d was increased to 20 mg/d in dyslipidemic patients.
Results:
The most pronounced effects of lifestyle changes were shown at 14 weeks and included significant differences in high-density lipoprotein cholesterol, low-density lipoprotein (LDL) cholesterol, salusin α, malondialdehyde-oxidized LDL, fructosamine, and monocyte CD36 expression. Immunoglobulin G anti-oxLDL showed the highest values at 21 weeks. Seven patients (16.7%) were nondyslipidemic at 21 weeks. In patients who continued to be dyslipidemic, LDL cholesterol and triglyceride levels significantly decreased, salusin α levels and CD36 expression increased, and dyslipidemia resolved in 59.4% of the patients following atorvastatin treatment.
Conclusions:
Lifestyle changes have selective efficacy in the treatment of dyslipidemia in HD patients, while atorvastatin (up to 20 mg/d) may be effective in about 60% of nonresponders to lifestyle changes. Lipid-lowering interventions affect plasma salusin α and monocyte CD36 expression.
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