Hyperlipidemia in children with chronic renal insufficiency

Total serum cholesterol, phospholipids, and triglyceride levels, lipoprotein fractionation, and plasma parathormone levels were measured in a group of 31 nonnephrotic children with various levels of renal function and on hemodialysis. Group A served as controls and consisted of eight healthy children with glomerular filtration rate (GFR) greater than 110 ml/min/1.73 m2. Group B consisted of six children with GFR on 60 to 95 ml/min/1.73 m2. Group C consisted of nine children with GFR of 10 to 40 ml/min/1.73 m2, and group D consisted of eight children on maintenance hemodialysis with GFR of 0 to 5 ml/min/1.73 m2. Among the groups, there were no significant differences in total serum cholesterol and phospholipid levels. A significant (P less than 0.05) increase in triglyceride levels was observed in patient groups C and D. Lipoprotein fractionation revealed a significant increase (P less than 0.05) in the pre-beta lipoprotein levels (very low density lipoproteins) in patients in groups D with 63% of these patients demonstrating a type IV lipoprotein pattern. There were no significant differences observed in the beta lipoproteins (low-density lipoproteins). However, the alpha lipoproteins (high-density lipoproteins) decreased significantly (P less than 0.05) in patients whose GFR was below 40 ml/min/1.73 m2 (group C) as well as patients in group D. Absolute plasma parathormone levels did not significantly correlate with serum triglyceride levels did not significantly correlate with serum triglyceride levels and remained normal until after the onset of hemodialysis when they increased significantly in all patients.