[Is hyperlipidemia a factor in the progression of renal failure?]

Many experimental results support the hypothesis that increased plasma lipid concentrations may have a deleterious effect on the course of chronic renal diseases. Until now a clear causal relationship has not been proved. Because reliable results of prospective controlled trials are not available that would demonstrate a beneficial effect of lipid-lowering interventions on the course of chronic renal diseases, it is not possible at this time to provide a general recommendation for a lipid-lowering drug therapy. Nevertheless, I would support the prescription of HMG CoA reductase inhibitors for patients with extremely increased total cholesterol and LDL cholesterol concentrations despite the restricted data of already existing experimental and clinical studies. It should be stressed that every patient with glomerular disease and concomitant hyperlipidemia constrains us to weigh advantages and side-effects of a lipid-lowering regimen. We have to wait for the results of prospective and controlled multicenter studies to give a final recommendation for therapeutic consequences in patients with chronic renal disease and hyperlipidemia.