Abstract :
Background & Objective: With increasing prevalence of Chronic Kidney Disease (CKD), CKD related
cardiovascular diseases (CVD), end stage renal disease (ESRD) and the consequent financial burden of
renal replacement therapy (RRT), the importance of CKD and its risk factors needs to be considered.
Hence, lipid profile was studied in maintenance hemodialysis (MHD) subjects.
Materials and Methods: An observational study consisting 100 patients diagnosed as ESRD on MHD
of age group 18-70 years of both sex were selected from Nephrology unit, KIMS, Hubballi. Serum lipid
profile was estimated by enzymatic method, urea by GLDH- Urease method, serum creatinine by Jaffe’s
method.
Results: A significant patients had low serum lipid levels with mean standard deviation of Total
cholesterol (mg/dl) 131.9349.75, Triacylglyceride (mg/dl) 107.53 52.36, HDL-C (mg/dl) 28.93 10.06
& LDL-C (mg/dl) 82.2342.89 and serum creatinine (mg/dl) 8.28 2.45 & Blood urea (mg/dl) 110.51
37.58
Conclusion: ESRD patients are at higher risk and it is expected to have serum lipids as per NCEP-ATP-III
guidelines. In contrast to this, where these levels are associated with increased risk of CVD, decrease values
in dialysis patients are strongly correlated with increased morbidity including a higher risk of cardiovascular
events and death. This observation is referred as “reverse epidemiology/risk factor–paradox”. It may be
due to superimposed factors like inflammation and/or malnutrition that lead to lower cholesterol levels. In
addition, chronic renal failure per se, primarily affects the metabolism of HDL-C and Triacylglyceride rich
lipoproteins. Despite conflicting reports, hypercholesterolemia paradoxically appears to be associated with
more favorable outcome in ESRD patients.
Keyword :
Cardiovascular disease, ERSD, Hypercholesterolemia, Inflammation, Maintenance hemodialysis, Malnutrition.