Vnitr Lek 2006, 52(11):1051-1057

Dyslipidemia in patients being treated with peritoneal dialysis

A. Zharfbin
II. interní klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Miroslav Souček, CSc.

Dyslipidemia endangers nephrological patients by its aterogenic effect as well as by the possibility of acceleration of renal damage progression.


The aim of our work was:
1. To determine the influence of peritoneal dialysis (PD) with standard (glucose) dialysis solution on concentration of blood lipids and lipoproteins during 30 months of treatment. 2. To compare these results with a group of patients on hemodialysis (HD) and in pre-dialysis (in patients with plasmatic creatinine 250-400 μmol/l).

Methods:
Concentrations of total cholesterol, LDL-cholesterol, HDL-cholesterol, non-HDL-cholesterol, triglycerides, lipoproteins(a), apolipoprotein A-1 and B, albumin, glucose, HbA1c and CRP were measured. We tested 24 patients on PD, 20 patients on HD and 20 patients in predialysis.

Results:
In patients on PD there was a statistically significant increase in total, non-HDL and LDL-cholesterol, lipoprotein(a) (p < 0.005), triglycerides (p < 0.05), and a decrease in HDL-cholesterol (p < 0.005), and we also observed a significant increase in CRP (p < 0.05) and in body mass index (p < 0.05) within 6 months. After 30 months of PD we detected a decrease in total cholesterol as well as in triglycerides to levels before the commencement of PD (p < 0.005). In patients on PD there were significantly higher values of non-HDL-cholesterol, LDL-cholesterol, lipoprotein(a), glucose, HbA1c, CRP and BMI in comparison with the group of patients on hemodialysis and the patients in pre-dialysis (p < 0,05). HDL-cholesterol remained significantly low even after 30 months (p < 0.05).

Conclusion:
Higher values of lipoprotein(a) and LDL-cholesterol, and decreased value of HDL-cholesterol in patients on peritoneal dialysis can have a negative influence on further prognosis of such patients as compared to patients on hemodialysis and those in pre-dialysis, and may contribute to a high risk for atherosclerosis in ESRD, especially in patients treated with CAPD.

Keywords: peritoneal dialysis; dyslipidemia; lipoprotein(a)

Received: April 16, 2004; Accepted: July 26, 2006; Published: November 1, 2006  Show citation

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Zharfbin A. Dyslipidemia in patients being treated with peritoneal dialysis. Vnitr Lek. 2006;52(11):1051-1057.
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