Dyslipidemia and the progression of renal disease in chronic renal failure patients

Abstract

Dyslipidemia is a common complication of progressive kidney disease and contributes to the high cardiovascular morbidity and mortality of chronic kidney disease (CKD) patients. Recent evidence also suggests a role for dyslipidemia in the development and progression of renal disease. Experimental studies have demonstrated that lipids may induce glomerular and tubulointerstitial injury, and that lipid-lowering treatments ameliorate renal injury. Various lipid abnormalities have been associated with the development and progression of renal disease in diabetic and nondiabetic patients. Population-based studies and studies of diabetic patients have reported associations of various lipid abnormalities with the development of renal disease. In patients with CKD, lipid abnormalities have also been associated with renal disease progression. Post hoc analyses of some large clinical trials on patients with vascular disease, diabetes, or dyslipidemia, and a meta-analysis of small, prospective, controlled studies on patients with CKD (diabetics and nondiabetics) suggest that statins may slow the progression of kidney disease. It is unclear whether the beneficial renal effects of statins are due to the reduction of serum cholesterol levels and/or their pleiotropic effects. There is also evidence for synergistic renoprotective effects between statins and renin-angiotensin system inhibitors. According to the results of post hoc analysis of several studies, treatment with fibrates does not seem to confer renoprotection, but evidence is scarce. In summary, there is growing evidence that lipid abnormalities may be a risk factor for renal disease, and that statins appear to confer a renoprotective effect.

Phenotype–genotype interactions on renal function in type 2 diabetes: an analysis using structural equation modelling

“…These metabolic, cellular and vascular effects can lead to endothelial dysfunction with cardiorenal manifestations [38,39]. In light of this, there is some preliminary evidence supporting additive effects of RAS inhibition and lipid lowering on reducing the rate of decline of renal function [40].…”

Paraoxonase enzyme activity and dyslipidemia in chronic kidney disease patients

“…Patients with CKD often have lipid abnormalities. CKD is associated with dysregulation in high density lipoprotein (HDL) and triglyceride metabolism (1,2). Therefore in the plasma of these patients, the level of triglyceride-rich lipoproteins is increased considerably.…”

“…Therefore in the plasma of these patients, the level of triglyceride-rich lipoproteins is increased considerably. Moreover, some alterations occurred in composition of these lipoproteins (1,2). Lipid abnormalities in CKD patients increase the risk of cardiovascular diseases in CKD patients (1,2).…”

Clinical Study on Autosomal Dominant Polycystic Kidney Disease among South Indians

“…Dyslipidemia is reported to be a common complication of progressive kidney disease [27]. Several studies have shown hypercholesterdemia and hypertriglycerdemia to be the risk factors for renal failure [23].…”

“…Hypertriglyceridemia is the most common plasma lipid abnormality in patients with renal failure [25,26]. Dyslipdemia is a common complication of progressive kidney disease which also contributes to high cardiovascular morbidity and mortality of renal disease patients [27].…”