Treatment of Hyperlipidemia Changes With Level of Kidney Function-Rationale
Autor: | George A. Kaysen, Shubha Ananthakrishnan |
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Rok vydání: | 2015 |
Předmět: |
medicine.medical_specialty
Nephrotic Syndrome medicine.medical_treatment Lipoproteins 030232 urology & nephrology Renal function Hyperlipidemias 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Hyperlipidemia medicine Gemfibrozil Humans Renal Insufficiency Chronic Dialysis business.industry Fibric Acids nutritional and metabolic diseases medicine.disease Nephrology Cardiology lipids (amino acids peptides and proteins) Metabolic syndrome Hydroxymethylglutaryl-CoA Reductase Inhibitors business Oxidized ldl Kidney disease Lipoprotein medicine.drug Glomerular Filtration Rate |
Zdroj: | Advances in chronic kidney disease. 23(4) |
ISSN: | 1548-5609 |
Popis: | Lipoprotein abnormalities such as low levels of high-density lipoprotein (HDL) and high triglycerides (TGs), associated with the metabolic syndrome, are also associated with subsequent decline in kidney function. Patients with end-stage kidney disease also exhibit low HDL and high TGs and a modest reduction in low-density lipoprotein (LDL), although the mechanisms responsible for these changes differ when patients with end-stage kidney disease are compared with those having metabolic syndrome with normal kidney function, as do lipoprotein structures. Among dialysis patients, oxidized LDL, levels of TG-rich intermediate-density lipoprotein, and low HDL are associated with aortic pulsewave velocity and other markers of atherosclerosis. Statins are effective in reducing LDL and do decrease risk of cardiovascular events in patients with CKD not requiring dialysis but have no significant effect on outcomes, including all-cause mortality among dialysis patients. Similarly gemfibrozil and other fibrates lower TGs, increase HDL, and reduce cardiovascular events, but not mortality, among patients with CKD not requiring dialysis but have no significant effect on cardiovascular outcomes in dialysis patients. There is potential clinical benefit in treating elevated LDL, TGs, and low HDL in patients with CKD using statins or fibrates in those not yet requiring dialysis. |
Databáze: | OpenAIRE |
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