Oct 27, 2018

Lipid management in patients with chronic kidney disease

Nature Reviews. Nephrology
Charles J FerroC Zoccali

Abstract

An increased risk of cardiovascular disease, independent of conventional risk factors, is present even at minor levels of renal impairment and is highest in patients with end-stage renal disease (ESRD) requiring dialysis. Renal dysfunction changes the level, composition and quality of blood lipids in favour of a more atherogenic profile. Patients with advanced chronic kidney disease (CKD) or ESRD have a characteristic lipid pattern of hypertriglyceridaemia and low HDL cholesterol levels but normal LDL cholesterol levels. In the general population, a clear relationship exists between LDL cholesterol and major atherosclerotic events. However, in patients with ESRD, LDL cholesterol shows a negative association with these outcomes at below average LDL cholesterol levels and a flat or weakly positive association with mortality at higher LDL cholesterol levels. Overall, the available data suggest that lowering of LDL cholesterol is beneficial for prevention of major atherosclerotic events in patients with CKD and in kidney transplant recipients but is not beneficial in patients requiring dialysis. The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Lipid Management in CKD provides simple recomme...Continue Reading

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  • Citations325
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Mentioned in this Paper

Patterns
Low Density Lipoprotein Cholesterol Measurement
Kidney Failure
Biological Products
CETP protein, human
Chronic Kidney Insufficiency
Omega-3 Fatty Acids
Dialysis Procedure
Kidney
Proprotein Convertase 9

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