Document Detail


Is lipid control necessary in hemodialysis patients?
MedLine Citation:
PMID:  19996012     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although high serum total cholesterol and LDL cholesterol levels are predictive of cardiovascular diseases in the general population, this association is more complex in the dialysis patients. Two recent randomized trials failed to show significant beneficial effects of statins on the primary cardiovascular outcomes in these patients. The reasons for this lack of benefits are unclear. The postulates include the possibilities that LDL cholesterol is not important in atherogenesis and that atherosclerosis is not a major contributor to cardiovascular diseases in the dialysis population. It is important to note that high serum LDL cholesterol level is not a prominent feature of uremic dyslipidemia. Instead, the hallmark dyslipidemias in the dialysis population are hypertriglyceridemia as a result of the accumulation of lipoprotein remnant particles, low serum HDL cholesterol levels, high serum levels of lipoprotein(a) [Lp(a)], and the modification of LDL cholesterol by oxidation and carbamylation. In vitro and epidemiologic studies have further suggested that these abnormal lipoproteins or aberrant serum lipoprotein levels are atherogenic. More research efforts should be directed toward these dyslipidemic states and the multitude of other putative cardiovascular risk factors in dialysis patients.
Authors:
Alfred K Cheung
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  4 Suppl 1     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-09     Completed Date:  2010-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S95-101     Citation Subset:  IM    
Affiliation:
Medical Service, Veterans Affairs Salt Lake City Healthcare System and Division of Nephrology and Hypertension and Dialysis Program, University of Utah, Salt Lake City, Utah, USA. alfred.cheung@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Antilipemic Agents / therapeutic use*
Biological Markers / blood
Cardiovascular Diseases / blood,  etiology,  prevention & control*
Dyslipidemias / blood,  complications,  drug therapy*
Humans
Hypercholesterolemia / complications,  drug therapy
Hypertriglyceridemia / complications,  drug therapy
Kidney Failure, Chronic / blood,  complications,  therapy*
Lipids / blood
Practice Guidelines as Topic
Renal Dialysis*
Risk Assessment
Risk Factors
Treatment Outcome
Uremia / etiology,  therapy
Chemical
Reg. No./Substance:
0/Antilipemic Agents; 0/Biological Markers; 0/Lipids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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