Lipid management in patients with chronic kidney disease

Ferro, C. J. et al. (2018) Lipid management in patients with chronic kidney disease. Nature Reviews Nephrology, 14(12), pp. 727-749. (doi:10.1038/s41581-018-0072-9) (PMID:30361677)

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An increased risk of cardiovascular disease, independent of conventional risk factors, is present even at minor levels of renal impairment and is highest in patients with end-stage renal disease (ESRD) requiring dialysis. Renal dysfunction changes the level, composition and quality of blood lipids in favour of a more atherogenic profile. Patients with advanced chronic kidney disease (CKD) or ESRD have a characteristic lipid pattern of hypertriglyceridaemia and low HDL cholesterol levels but normal LDL cholesterol levels. In the general population, a clear relationship exists between LDL cholesterol and major atherosclerotic events. However, in patients with ESRD, LDL cholesterol shows a negative association with these outcomes at below average LDL cholesterol levels and a flat or weakly positive association with mortality at higher LDL cholesterol levels. Overall, the available data suggest that lowering of LDL cholesterol is beneficial for prevention of major atherosclerotic events in patients with CKD and in kidney transplant recipients but is not beneficial in patients requiring dialysis. The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Lipid Management in CKD provides simple recommendations for the management of dyslipidaemia in patients with CKD and ESRD. However, emerging data and novel lipid-lowering therapies warrant some reappraisal of these recommendations.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Mark, Dr Patrick
Authors: Ferro, C. J., Mark, P. B., Kanbay, M., Sarafidis, P., Heine, G. H., Rossignol, P., Massy, Z. A., Mallamaci, F., Valdivielso, J. M., Malyszko, J., Verhaar, M. C., Ekart, R., Vanholder, R., London, G., Ortiz, A., and Zoccali, C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Nature Reviews Nephrology
Publisher:Nature Publishing Group
ISSN (Online):1759-507X
Published Online:25 October 2018
Copyright Holders:Copyright © 2018 Springer Nature
First Published:First published in Nature Reviews Nephrology 14(12): 727-749
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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