Lipid profile and lipoprotein(a) in chronic renal failure patients with and without hemodialysis

Abstract

Objectives: Chronic renal failure (CRF) is complicated by characteristic dyslipidemias. CRF patients on hemodialysis have abnormalities in lipid profile and have a high incidence of cardiovascular diseases. Lipoprotein(a) [Lp(a)] is now considered as a novel cardiovascular risk factor and its level is increased in CRF patients with and without hemodialysis. We sought to evaluate the pattern of lipid profile including Lp(a) level in CRF patients with and without hemodialysis. Methodology: Study were divided into 3 groups, Group-I: healthy controls (30), Group-II: CRF patients who never undergone hemodialysis (30) and Group-III: CRF patients on hemodialysis for more than 6 months (30). We obtained serum samples from patients in the morning after an overnight fast and were analysed for total cholesterol (TC), triglycerides (TGs), HDL, LDL, Lp(a) using standard colorimetric assays on fully automated analyzer. VLDL concentration was calculated using Friedewald's Formula. Results: Among the various parameters tested triglyceride and VLDL levels were significantly higher in group-II and III as compared to controls (p<0.01). HDL levels were significantly lower in group-II and III as compared to control (p<0.05). HDL level was found reduced in group-III as compared to Group-II (p<0.01). There was no significant change (p>0.05) observed in total cholesterol and LDL levels in between healthy controls and CRF patients with & without hemodialysis. Lp(a) levels were significantly higher in group-II and III as compared to controls (p<0.01) but the difference between Lp(a) levels in group-II and III was found insignificant (p>0.05). There was no significant difference (p>0.05) observed between Lp(a) levels and lipid profile in male and female patients in control group and in CRF patients with and without hemodialysis. Conclusions: This study demonstrated that CRF patients with and without hemodialysis are at greater risk of development of dyslipidemias, characterized by hypertriglyceridemia, elevated VLDL and Lp(a) levels and decreased HDL levels. Total cholesterol and LDL cholesterol levels remain normal or decreased in these patients. Both male and female patients of CRF with and without hemodialysis have dyslipidemias without any discrimination of sex and it is not attenuated by the hemodialysis process.

A cross-sectional study to assess proteinuria and lipoprotein (a) levels in chronic kidney disease

“…The study findings can be compared with that of Sudha Rani J et al [16], in which the mean serum lipoprotein (a) levels of cases were 73.6 ± 3.8 mgs % (reference range: 62 to 82) while that of controls (reference range: 15 to 26) was 21.2 ± 3.3 mgs % and also the difference was statistically significant. In addition, according to Sharma H et al [17], the mean serum lipoprotein (a) levels of CKD cases who were on hemodialysis was higher than that of controls. However, this difference was found to be not statistically significant.…”

To Correlate the Association of Markers of Chronic Renal Failure in Patients With and without Haemodialysis

“…Regarding triglycerides level, we observed that there was highly significant rise in CRF without haemodialysis, still more high level to this second group was found in CRF with haemodialysis (p<0.01) as compared to healthy controls. Different studies also shown that hyper triglyceridemia is very well there in CRF patients with or without haemodialysis [10][11][12]. It has been said that hyper triglyceridemia in CRF patients is due to decreased activity of lipoprotein lipase and increased triglyceride synthesis by liver from free fatty acids released from fatty tissue [13].…”