TMSS Medical College Journal

Background:Dyshpidema is a very common compncanon or cnromie kiancy ascase (RD)pancnts wm maintenance hemodialysis (MHD).CKD is an increasing health problem all around the world.End stage renal disease (ESRD)patients are treated with hemodialysis.It is a recognized risk factor of cardiovascular disease and progression of renal disease of various ctiologics.Objective:To observe the lipid profile in CKD patients with MHD.Methodology:This cross sectional comparative study was carried out in the Department of Biochemistry,Dhaka Medical College,Dhaka during the period of July 2013 to June 2014.A total number of 100 subjects of both sexes were selected with age ranging from 18 to 60 years.Among them,50 CKD patients with maintenance hemodialysis (MHD)were included in group I and 50 health subjects in group II.Serum lipid profile of all the groups was assessed and statistically compared.For statistical analysis unpaired student t-test was performed using SPSS for windows version 16.Results:The mean (+SD)of serum TG level was significantly higher and serum HDL-C level was significantly lower in CKD patients with MHD (172.22 32.83 and 33.60 5.45)than healthy control group (140.44 37.99 and 39.94 9.26). Conclusion: Dyslipidemia is more common in CKD patients with MHD than the healthy control.

Chronic kidney disease (CKD)is becoming a worldwide health problem due to increasing incidence and prevalence.1 It is a pathophysiological process with multiple etiologies resulting in the inexorable attrition of functional nephrons and frequently leading to end stage renal disease (ESRD)necessitating hemodialysis as a mandatory therapeutic measure. Kidney Disease Outcomes Quality Initiative (K/DOQD)defines CKD as either kidney damage for=3months,as defined by structural or functional abnormalities of kidney,with or without decreased glomerular filtration rate (GFR)or GFR <60 ml/min/1.73m2 for =3 months,with or without kidney damage.2 CKD causes metabolic abnormalities of plasma lipids both qualitatively and quantitatively.3 The incidence and prevalence of chronic kidney diseases (CKD)are increasing worldwide and has s become a major health problem4.Approximately 50%of patients with end-stage renal disease (ESRD)die from cardiovascular events,5 which indicate that cardiovascular mortality is 30-times higher in CKD patients.The Kidney Dialysis Outcome Quality Initiative (K/DOQI)guidelines state that patients on MHD with fasting triglycerides (TG) >5.65 mmol/L,low density lipoprotein (LDL) >2.59 mmol/L and non-HDL cholesterol >3.36 mmol/L,should be considered for treatment of dyslipidemia to reduce the cardiovascular complications in these patients.6 Dyslipidemia has been established as a well known traditional risk factor for CVD in the general population as well as in CKD patients on MHD.CKD is known to cause an increase in triglycerides and a decrease in high-density lipoprotein that mimic the lipid abnormalities of the metabolic syndrome,which accelerate the progresssion of CKD and increase the risk for cardiovascular mortality.Hemodialysis patients usually display elevated TG,reduced serum high density lipoprotein(HDL)cholesterol and elevated concentration of lipoprotein-a(LP-a). Total and LDL cholesterol levels usually remain within normal limits.?Cholesterol levels may be lower in MHD patients.There is an inverse relationship between mortality and the cholesterol concentration.8 This pattern of reverse epidemiology, i.e., hypercholesterolemia associated with decreased mortality and low cholesterol concentration associated with increased CVD mortality seen in MHD patients has been related to the malnutrition-inflammation- atherosclerosis complex.9 Keeping in view the mortality associated with CVD in patients on MHD,we investigated the serum lipid status in CKD patients undergoing long-term hemodialysis (>3 months)treatment and compared the values with healthy subjects.