Treatment options for dyslipidemia in chronic kidney disease and for protection from contrast-induced nephropathy

Abstract

Chronic kidney disease (CKD) is highly prevalent worldwide and represents a major cardiovascular risk factor. Dyslipidemia is present in most patients with CKD and further worsens CKD, creating a vicious cycle. The treatment of CKD-related dyslipidemia has been a controversial topic. The use of statins is recommended in all stages of CKD, but it appears to reduce cardiovascular and renal events only in the early CKD stages, up to stage 3. The use of atorvastatin has proven very beneficial; thus, the earliest we start statin treatment, the better for the patient. Atorvastatin and pitavastatin do not need dose adjustments at any level of renal function. Fibrates can be administered in mixed hyperlipidemia, combined with statins in early CKD stages. Omega-3 fatty acids are useful for treating hypertriglyceridemia in CKD. Antibodies against proprotein convertase subtilisin/kexin type 9 hold promise for a better control of dyslipidemia and a greater reduction of cardiovascular risk.

Atherogenic Index of Plasma is an Independent Risk Factor for Contrast Induced Nephropathy in Patients With Non-ST Elevation Myocardial Infarction

“…However, it has been shown in many clinical studies that dyslipidemia treatment reduces the possibility of CIN development. 44,45 In a study, a relationship was found between HDL-C level and the development of CIN. 46 We found a significant relationship between AIP and the development of CIN in our study.…”

Obesity-Related Glomerulopathy: Epidemiology, Pathogenesis, and Current Treatments

“…Hyperlipidemia is associated with the progression of chronic renal disease. [27] In vitro studies have demonstrated that interleukin-1β can promote the absorption of low-density lipoprotein (LDL) and inhibit lipid excretion, thus leading to the formation of foam cells and aggravating renal damage. [28] Recent studies have also indicated that increased lipid endocytosis in podocytes from ORG patients leads to proteinuria and glomerular sclerosis.…”

Contrast-induced acute kidney injury: beware of the risk after coronary angiography

“…Furthermore, deterioration of kidney function may occur after contrast media administration, even in the absence of CI-AKI [2]. Periprocedural statin use, hydration, N-acetylcysteine, and adenosine antagonists have been reported to help prevent CI-AKI after coronary angiography [4][5][6].…”