Dyslipidemia in Chronic Kidney Disease: Contemporary Concepts and Future Therapeutic Perspectives

Theofilis, Panagiotis; Vordoni, Aikaterini; Koukoulaki, Maria; Vlachopanos, Georgios; Kalaitzidis, Rigas

doi:10.1159/000518456

Cited by 26 publications

(17 citation statements)

References 87 publications

(82 reference statements)

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“…As an example, lipoprotein size and concentration have been established as stronger predictors for adverse outcomes in CKD [ 18 ]. However, they cannot be assessed in routine clinical practice in most centres [ 19 ]. NEFRONA recruited persons with no previous history of CVD and free from diabetes, rendering a low-risk population.…”

Section: Discussionmentioning

confidence: 99%

Triglycerides–glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease

Quiroga

Ramos

Horrillo

et al. 2022

Clinical Kidney Journal

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Background Chronic kidney disease (CKD) is associated to high rates of cardiovascular events. We here explored whether the recently described triglycerides-glucose index (TyG) predicted the incidence of major adverse cardiovascular events (MACE) in these patients. Methods Observational study of 1142 persons with CKD and free from diabetes and 460 controls from the prospective NEFRONA study. The study exposure was the TyG index at cohort inclusion. The study outcome was MACE (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke and hospitalization for unstable angina). Covariates included demographics, comorbidities, lipid profile, renal function and glycemic control. Cox regression models evaluated the association between TyG index and 4-point MACE in Patients with CKD. Results TyG was higher (median 8.63 IQR [8.32-8.95] in patients with CKD compared to controls (p<0.001). TyG increased across albuminuria categories but was similar for glomerular filtration rate categories among patients with CKD stages 3-5. During 46±13 months of follow-up, 49 (4.3%) MACE were registered. TyG predicted the occurrence of MACE (HR 1.95, 95%CI [1.11-3.40] per TyG unit increase; and HR 2.29, 95%CI [1.24-4.20] for TyG values above the median of 8.63 units). Sensitivity analysis for subgroups of participants according to age, kidney function, body mass index and imaging evidence of atherosclerosis yielded similar results, as did adjusted analysis. Neither triglycerides nor glucose alone were associated with MACE. Conclusions The TyG index is associated with the occurrence of major cardiovascular events in persons free from diabetes with non-dialysis dependent CKD.

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Section: Discussionmentioning

confidence: 99%

Triglycerides–glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease

Quiroga

Ramos

Horrillo

et al. 2022

Clinical Kidney Journal

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“…Hypertriglyceridemia occurs because of both the delayed catabolism and the increased hepatic production of triglyceride-rich lipoproteins. It is also possible that secondary hyperparathyroidism plays an additional role in triglyceride-rich lipoprotein catabolism impairment, resulting in raised plasma triglyceride concentrations associated with CKD" [34].…”

Section: Resultsmentioning

confidence: 99%

Evaluation of YKL-40 as a Biomarker of Inflammation and Atherosclerosis in Chronic Kidney Disease Patients

El-Ghorab

Elshafey²,

Negm³

et al. 2022

JAMMR

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Background: Chronic kidney disease (CKD) has been recognized as a leading public health problem worldwide. In Egypt, CKD approximately affects 13% of the adult population, resulting in significant morbidity, mortality, and health care costs. Patients with advanced CKD (stage 3 or more) experience a high rate of cardiovascular complications compared to earlier stages of CKD. Objective: To evaluate serum YKL-40 levels in patients with CKD to assess its value as a biomarker of inflammation and its correlation with carotid intima-media thickness (CIMT) as a predictor for early atherosclerosis. Patients and Methods: The present study was conducted on fifty subjects divided into 2 groups: group I includes 25 patients with CKD (from stage 1 to stage 5 "pre-dialysis") and group II (control group) includes 25 healthy volunteers. The patients were recruited from Internal Medicine Department and Nephrology Unit, Tanta university hospitals in the period between," August 2020 to September 2021 ". Results: In our study, YKL-40 levels were significantly high in CKD patients(P=0.001). As regards CIMT measurements for the studied cases its median value was 0.90 and1 mm for the right and left carotid respectively. On the other hand, CIMT measurements for the studied volunteers were within the normal range with statistically significant differences between both groups (p=0.001). There is a positive significant correlation between the serum YKL-40 level from the studied cases with each of triglycerides, serum urea, serum creatinine, CRP, ESR, R CIMT, and L CIMT. Systolic blood pressure, triglyceride, cholesterol, LDL, serum urea, serum creatine, e-GFR, ESR, CRP, and YKL-40 were found to be independent predictors for CIMT (P<0.05). Serum YKL-40 is a highly sensitive predictor of atherosclerosis in CKD and its specificity is 74% in CKD cases. Conclusion: Serum YKL-40 was significantly high in CKD patients. YKL-40 could be used as a biomarker for inflammation and early detection of atherosclerosis in patients with CKD, but further studies are needed. YKL-40 is an independent predictor of increased CIMT and early atherosclerosis. YKL-40 is highly sensitive to increased CIMT.

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“…Frailty is known to develop in older individuals with multiple comorbidities, in particular CVD, CKD, and DM2 [75][76][77]. The pattern of laboratory tests fit to this clinical context, as seen by lower Hb and HDL cholesterol and higher triglycerides than in the other two clusters, which could have been the effect of lower renal function and frailty [13,38,78]. The frailty in patients in this cluster could also explain the somewhat distorted body shape, as shown by the modest "BMI" values combined with disproportionally lower "mac" values, indicating more muscle than weight loss.…”

Section: Discussionmentioning

confidence: 95%

Clustering Inflammatory Markers with Sociodemographic and Clinical Characteristics of Patients with Diabetes Type 2 Can Support Family Physicians’ Clinical Reasoning by Reducing Patients’ Complexity

et al. 2021

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Diabetes mellitus type 2 (DM2) is a complex disease associated with chronic inflammation, end-organ damage, and multiple comorbidities. Initiatives are emerging for a more personalized approach in managing DM2 patients. We hypothesized that by clustering inflammatory markers with variables indicating the sociodemographic and clinical contexts of patients with DM2, we could gain insights into the hidden phenotypes and the underlying pathophysiological backgrounds thereof. We applied the k-means algorithm and a total of 30 variables in a group of 174 primary care (PC) patients with DM2 aged 50 years and above and of both genders. We included some emerging markers of inflammation, specifically, neutrophil-to-lymphocyte ratio (NLR) and the cytokines IL-17A and IL-37. Multiple regression models were used to assess associations of inflammatory markers with other variables. Overall, we observed that the cytokines were more variable than the marker NLR. The set of inflammatory markers was needed to indicate the capacity of patients in the clusters for inflammatory cell recruitment from the circulation to the tissues, and subsequently for the progression of end-organ damage and vascular complications. The hypothalamus–pituitary–thyroid hormonal axis, in addition to the cytokine IL-37, may have a suppressive, inflammation-regulatory role. These results can help PC physicians with their clinical reasoning by reducing the complexity of diabetic patients.

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Dyslipidemia in Chronic Kidney Disease: Contemporary Concepts and Future Therapeutic Perspectives

Cited by 26 publications

References 87 publications

Triglycerides–glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease

Triglycerides–glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease

Evaluation of YKL-40 as a Biomarker of Inflammation and Atherosclerosis in Chronic Kidney Disease Patients

Clustering Inflammatory Markers with Sociodemographic and Clinical Characteristics of Patients with Diabetes Type 2 Can Support Family Physicians’ Clinical Reasoning by Reducing Patients’ Complexity

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