Dyslipidemia in patients being treated with peritoneal dialysis

Česká verzia

Authors: A. Zharfbin
Authors place of work: II. interní klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Miroslav Souček, CSc.
Published in the journal: Vnitř Lék 2006; 52(11): 1051-1057
Category: Original Contributions

Summary

Dyslipidemia endangers nephrological patients by its aterogenic effect as well as by the possibility of acceleration of renal damage progression.

The aim of our work was:
1. to determine the influence of peritoneal dialysis (PD) with glucose dialysis solution on concentration of blood lipids during 30 months of treatment. 2. To compare these results with a group of patients on hemodialysis (HD) and in pre-dialysis with creatinine 250 - 400 µmol/l.

Methods:
There was estimated the concentration of total cholesterol, LDL-cholesterol, HDL-cholesterol, non-HDL-cholestreol, triglycerides, lipoproteins(a), apolipoprotein A-1 and B, albumin, glucose, HbA_1c and CRP. There was investagated 24 patients on PD, 20 patients on HD and 20 patients in predialysis.

Results:
In patients on PD there was statistically significant increase of total, non-HDL and LDL-cholesterol, lipoprotein(a) (p < 0.005), triglycerides (p < 0.05) and decrease of HDL-cholesterol (p < 0.005), we observed also significant increase of CRP (p < 0.05) and body mass index BMI (p < 0.05) within 6 months. After 30 months of PD was detected decrease of total cholesterol as well as decrease of triglycerides to the level before commencing PD (p < 0.005). In patients on PD there were significantly higher values of non-HDL-cholesterol, LDL-cholesterol lipoprotein(a), glucose, HbA_1c, CRP and BMI in comparison to the group of patients on hemodialysis and patients in pre-dialysis (p < 0,05). HDL-cholesterol has reamind significantly decreased even after 30 months (p < 0.05).

Conclusion:
Higher values of lipoprotein(a), LDL-cholesterol and decreased value of HDL-cholesterol in patients on peritoneal dialysis can have a negative influence of the prognosis of these patients comparing to the patients on hemodialysis and in pre-dialysis and may contribute to the high risk for atherosclerosis in ESRD, especially in patient treated by CAPD.

Keywords:
peritoneal dialysis - dyslipidemia - lipoprotein(a)

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