Cholesterol Disturbances and the Role of Proper Nutrition in CKD Patients

Abstract

Chronic kidney disease (CKD) is a widespread disease with increasing prevalence in the modern society. Lipid disturbances are common in this group of patients. In most patients with CKD atherogenic dyslipidemia is observed. Dyslipidemia in patients with renal diseases increases the risk of cardiovascular diseases and it accelerates the progression of chronic kidney disease to its end stage. The amelioration of dyslipidemia and the lowering of oxidative stress, inflammatory processes, insulin sensitivity and remnant lipoproteins levels may lead to the reduction in cardiovascular burden. Nutritional interventions can strengthen the beneficial effect of treatment and they play an important role in the preservation of overall well-being of the patients with CKD since the aim of appropriate diet is to reduce the risk of cardiovascular events, prevent malnutrition, and hamper the progression of kidney disease. The management of dyslipidemia, regardless of the presence of chronic kidney disease, should be initiated by the introduction of therapeutic lifestyle changes. The introduction of diet change was shown to exert beneficial effect on the lipid level lowering that reaches beyond pharmacological therapy. Currently available evidence give the impression that data on dietary interventions in CKD patients is not sufficient to make any clinical practice guidelines and is of low quality.

Maternal betaine supplementation decreases hepatic cholesterol deposition in chicken offspring with epigenetic modulation of SREBP2 and CYP7A1 genes

“…Cholesterol is essential to cell viability and functions. Cholesterol not only constitutes cell membranes but also serves as a precursor for the biosynthesis of steroid hormones, oxysterols, and bile acids, all of which play critical roles in health and disease ( Sozen and Ozer, 2017 , Benito-Vicente et al., 2018 , Gluba-Brzozka et al., 2019 ). The liver is the main site for cholesterol metabolism and thus serves as a control center for the maintenance of cholesterol homeostasis in the body.…”

There is a U shaped association between non high density lipoprotein cholesterol with overall and cardiovascular mortality in chronic kidney disease stage 3–5

“…In addition, a large cohort study of 38,377 patients with an eGFR 15–59 ml/min/1.73 m 2 reported that a serum HDL cholesterol level > 60 mg/dl was associated with higher risks of all-cause and cardiovascular mortality in male CKD patients 44 . Although low HDL cholesterol is a typical feature of lipid disturbance in CKD, many reports have demonstrated a decrease in HDL antioxidants and anti-inflammatory activity in patients with CKD at any stage 45 – 47 . Furthermore, many studies have demonstrated that HDL cholesterol can change from an anti-inflammatory to a pro-inflammatory molecule in patients with advanced CKD 48 , 49 .…”

The Effect of Ilex × meserveae S. Y. Hu Extract and Its Fractions on Renal Morphology in Rats Fed with Normal and High-Cholesterol Diet

“…It is noteworthy that cholesterol modulates the bilayer structure parameters of biological membranes, such as thickness, compressibility, water penetration. However, high cholesterol and triglyceride plasma levels have been demonstrated to be important risk factors for the progression of kidney disease and high total cholesterol or reduced HDL (high-density lipoprotein) cholesterol can decrease glomerular filtration rate [ 8 ].…”