Study of Severity and Pattern of Dyslipedemia in Chronic Kidney Disease

Abstract

Introduction: Coronary artery disease is a major cause of morbidity and mortality in patients with Chronic Kidney Disease (CKD). Dyslipidemia is an established coronary artery disease in the general population. Patients with CKD exhibit signi􀃶cant alterations in lipoprotein metabolism, which in their most advanced form may result in the development of severe dyslipidemia which can lead to increased risk of cardiovascular complications. However, this relationship is less clear, and many studies show that low, rather than high, cholesterol levels predict mortality in this patient population. The aim of this study was to determine the prevalence and pattern of dyslipidemia in patients of CKD. Method: This study was carried out in Dhiraj Hospital affiliated with SBKS MIRC after IEC approval, 50 patients of CKD according to KDOQI guidelines were enrolled after obtained written informed consent. Patients who were already diagnosed as having CAD, receiving haemodialysis, were on statin therapy were excluded from study. Detailed history and clinical examination done in all patients. Fasting lipid pro􀃶le was done in all participants. Abnormality in any one of lipid components (Cholesterol, Triglyceride, HDL-C, LDL-C, VLDL) considered as dyslipidemia. Result: Out of 50 patients of CKD , 27(54%) patients were having dyslipidemia according to NCEP-ATP III guidelines. No correlation were found between in age, gender, BMI, HTN, DM and addiction with occurance of dyslipidemia in CKD patients (P-value=<0.05). Mean values of all lipid components were in normal range except for VLDL. Most common lipid abnormality found was increased VLDL (30%) followed by hypertriglyceridemia (24%), decreased HDL-C in (18%), increased LDL-C in (10%). Hypercholesterolemia was detected in only 8% of patients. Mixed dyslipidemia was also noted. Hypertriglyceridemia + Increase VLDL was most common (25.9%) among them. Mean CR/CL was 10.18±5.95 for study population. Stage 5 CKD patients are having slightly more prevalence of dyslipidemia (57.5%) than stage 4 CKD (40%). Conclusion: Higher prevalence of cardiovascular complications are found in CKD patients due to accelerated atherosclerosis leading to high risk of mortality. Dyslipidemia is one of the common risk factor for atherosclerotic changes in patients of CKD. This study con􀃶rms the high prevalence for of atherogenic lipid pro􀃶le in patients of CKD which can lead to increased morbidity and mortality due to additional cardiovascular risks.