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Lipids, lipoproteins and apolipoproteins abnormalities in patients undergoing dialysis
Insights
Patients on continuous ambulatory peritoneal dialysis (CAPD) show more severe lipid and lipoprotein abnormalities than hemodialysis (HD) patients, suggesting a higher risk for coronary artery disease in CAPD patients.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Patients with end-stage renal disease often exhibit dyslipidemia.
- Both hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) are common renal replacement therapies.
- Dyslipidemia is a significant risk factor for cardiovascular disease in dialysis patients.
Purpose of the Study:
- To compare lipid, lipoprotein, and apolipoprotein profiles in HD and CAPD patients.
- To assess the impact of dialysis modality on these metabolic abnormalities.
- To evaluate the relative risk of coronary artery disease associated with each dialysis type.
Main Methods:
- Cross-sectional study comparing 20 HD patients and 20 CAPD patients.
- Analysis of serum lipids (total cholesterol, triglycerides, HDL-C, LDL-C).
- Measurement of apolipoproteins (Apo A-I, Apo B) and calculation of Apo B/Apo A-I ratio.
Main Results:
- HD patients showed elevated triglycerides and decreased HDL-C and Apo A-I.
- CAPD patients exhibited elevated total cholesterol, triglycerides, LDL-C, Apo B, and Apo B/Apo A-I ratio, with decreased HDL-C and Apo A-I.
- Peritoneal molecular sieving in CAPD negatively impacts lipid profiles more than HD.
Conclusions:
- CAPD is associated with a more atherogenic lipid profile compared to HD.
- CAPD patients may face a greater risk of coronary artery disease due to these metabolic disturbances.
- Both dialysis modalities confer increased cardiovascular risk compared to the general population.
Abstract:
Twenty hemodialysis (HD) patients and 20 patients on continuous ambulatory peritoneal dialysis (CAPD) were investigated for lipids, lipoproteins and apolipoproteins abnormalities. HD patients had elevated serum triglyceride, decreased high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (Apo A-I), while CAPD patients had elevated total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), Apolipoprotein B (Apo B), Apo B/Apo A-I ratio, and decreased HDL-C, Apo A-I. Because of the molecular sieving effects of peritoneum, CAPD have a negative effect on these abnormalities. CAPD patients might be at greater risk of developing coronary artery disease than HD patients who are also at increased risk as compared with normals.