Treatment of dyslipidemia in chronic renal failure

Dyslipidemia in end-stage renal disease is a common problem and may contribute to the high rates of morbidity and mortality in this population. Recent studies indicate that defective lipolysis is a major factor in the development of this disorder which is characterized by increased levels of very-low-density-lipoprotein remnant particles, hypertriglyceridemia and occasionally hypercholesterolemia. There are no prospective long-term studies on the effect of lipid-lowering treatment on morbidity and mortality related to dyslipidemia. Therefore, at present pharmacologic treatment of hyperlipidemia should be undertaken in patients with severe hypertriglyceridemia (> 500 mg/dl) or hypercholesterolemia (LDL > 130 mg/dl) who are at high risk for coronary artery disease. This review discusses the pathogenesis of dyslipidemia, common clinical patterns of hyperlipidemia and various nonpharmacologic and pharmacologic treatment options.