Lipid Disorders in Patients with Renal Failure: Role in Cardiovascular Events and Progression of Chronic Kidney...

Area of Science:

• Nephrology
• Cardiology
• Lipidology

Background:

• Chronic kidney disease (CKD) significantly elevates cardiovascular morbidity and mortality.
• Lipid disorders in renal failure present distinct patterns compared to the general population, not solely centered on LDL-C.
• CKD necessitates a specialized understanding of dyslipidemia due to its unique mechanisms and clinical implications.

Purpose of the Study:

• To review current evidence on the mechanisms, clinical impact, and treatment of dyslipidemia in renal failure.
• To emphasize the role of dyslipidemia in cardiovascular events and CKD progression.
• To synthesize recent findings on managing lipid abnormalities in CKD patients.

Main Methods:

• A narrative review approach was employed.
• Literature search conducted across PubMed/MEDLINE, Scopus, and Web of Science.
• Focused on publications from January 2018 to April 2026.

Main Results:

• CKD dyslipidemia features triglyceride-rich lipoproteins, remnant particles, modified LDL, and dysfunctional HDL.
• A uremic-inflammatory milieu contributes to endothelial injury, vascular calcification, and residual cardiovascular risk.
• These lipid abnormalities may promote renal lipotoxicity and fibrosis, though causality is not fully established.

Conclusions:

• Statin therapy is key for non-dialysis CKD patients.
• Lipid management in dialysis, transplant, frail patients, and severe hypertriglyceridemia requires personalized approaches.
• Future risk assessment should integrate lipid, inflammatory, vascular, nutritional, and renal markers, moving beyond LDL-C alone.