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Are lipid abnormalities reliable cardiovascular risk factors in dialysis patients?
F Bergesio1, R Ciuti, M Salvadori
1Department of Nephrology and Dialysis, New Hospital of S. Giovanni di Dio, Florence, Italy.
Insights
Lipid abnormalities in chronic hemodialysis patients are not reliable indicators of cardiovascular disease (CVD). This study found age and blood pressure, not lipids, were associated with CVD in dialysis patients.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Patients on chronic hemodialysis frequently have hyperlipidemia and a high incidence of cardiovascular disease (CVD).
- Uremic hyperlipidemia is often considered a significant cardiovascular risk factor (CVRF) in this population.
- The association between uremia-induced lipid abnormalities and actual CVD in dialysis patients requires further investigation.
Purpose of the Study:
- To determine if "uremia-induced" lipid abnormalities are associated with evidence of uremic CVD.
- To assess the reliability of these lipid abnormalities as cardiovascular risk factors (CVRF) in chronic dialysis patients.
Main Methods:
- Review of 123 patients undergoing chronic dialysis.
- Assessment of cardiovascular disease (CVD) presence.
- Examination of lipoprotein patterns and other clinical and biochemical variables.
Main Results:
- Lipids and lipoproteins were not helpful in identifying patients with CVD.
- CVD patients were significantly older and had higher blood pressure than non-CVD patients, despite shorter dialysis duration.
- Data suggest uremia-induced lipid abnormalities are not reliable CVD markers in dialysis patients.
Conclusions:
- Uremia-induced lipid abnormalities are not reliable markers of cardiovascular disease (CVD) in dialysis patients.
- The findings support the hypothesis that dialysis itself does not accelerate atherosclerosis in uremic patients.
- Age and hypertension appear to be more significant factors associated with CVD in this cohort.
Abstract:
Patients on chronic hemodialysis often present both hyperlipidemia and a high incidence of cardiovascular disease (CVD). Uremic hyperlipidemia has usually been regarded as one of the most important cardiovascular risk factors (CVRF) in these patients. In order to study whether the "uremia-induced" lipid abnormalities are actually associated with evidence of uremic CVD, and consequently may be considered reliable CVRF, 123 patients on chronic dialysis were reviewed for the presence of CVD and, at the same time, examined for their lipoprotein pattern and other clinical and biochemical variables. Lipids and lipoproteins did not prove helpful in our study in identifying patients with CVD. Despite the fact that they had been on dialysis for a shorter time, CVD patients were significantly older and had higher blood pressure than patients without CVD. Our data suggest that the uremia-induced lipid abnormalities are not reliable markers of CVD in dialysis patients, and support the hypothesis that dialysis per se does not accelerate the atherosclerotic process in uremic patients.