Evaluation of Lipid Profile Changes in Patients during One Year after the Onset of Peritoneal Dialysis

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Chronic renal failure refers to an irreversible deterioration of renal function that follows a progressive course and ultimately leads to necessity of dialysis in most of patients. As some studies have indicated that the mentioned patients may eventually develop lipid profile abnormalities, the present study aimed to evaluate the effective factors in lipid profile changes in these patients over one year.Methods: In this cross-sectional study, 251 patients under peritoneal dialysis, whose profiles were available in the archives of Alzahra hospital, Isfahan, Iran, during 2018-2019, were randomly selected. Demographic data and lipid profile of these patients including total cholesterol (TCH), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and blood glucose levels were recorded and analyzed at baseline as well as six months and one year after the start of dialysis.Findings: Changes in the lipid profile of the patients during one year of dialysis were significant (P < 0.050). Sexuality had a direct and significant relationship with all the changes in lipid profile items (P < 0.001). In addition, as well as an increase in the hemoglobin (Hb) level, it had a direct and significant relationship with elevated levels of LDL, TCH, and TG (P < 0.001 for all). Moreover, blood glucose level had a significant relationship with increased levels of TCH (P = 0.040) and TG (P = 0.014). Finally, dialysis solution with 2.5% and 4.25% dextrose had a significant and direct effect on increasing the levels of TCH (P =0.035) and LDL (P = 040), respectively.Conclusion: According to the results of the present study, the lipid profiles of patients undergoing peritoneal dialysis revealed significant changes. The most significant factors associated with lipid profiles were the type of dialysis solution, and the levels of blood glucose and Hb.

Keywords

References

  1. Shorecki K, Green J, Brenner BM. Chronic renal failure. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s principles of internal medicine. 16th ed. New York, NY: McGraw-Hill; 2005. p. 1653-63.
  2. Davison SN. End-of-life care preferences and needs: Perceptions of patients with chronic kidney disease. Clin J Am Soc Nephrol 2010; 5(2): 195-204.
  3. Mehrotra R, Chiu YW, Kalantar-Zadeh K, Bargman J, Vonesh E. Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease. Arch Intern Med 2011; 171(2): 110-8.
  4. Naini AE, Keyvandarian N, Mortazavi M, Taheri S, Hosseini SM. Effect of Omega-3 fatty acids on blood pressure and serum lipids in continuous ambulatory peritoneal dialysis patients. J Res Pharm Pract 2015; 4(3): 135-41.
  5. Baradaran A. Beyond mineral metabolism, the bright immunomodulatory effect of vitamin D in renal disease. J Nephropharmacol 2012; 1(2): 17-8.
  6. Rouhi H, Ganji F. Effects of N-acetyl cysteine on serum lipoprotein (a) and proteinuria in type 2 diabetic patients. J Nephropathol 2013; 2(1): 61-6.
  7. Yamamoto S, Yancey PG, Ikizler TA, Jerome WG, Kaseda R, Cox B, et al. Dysfunctional high-density lipoprotein in patients on chronic hemodialysis. J Am Coll Cardiol 2012; 60(23): 2372-9.
  8. Helal I, Smaoui W, Hamida FB, Ouniss M, Aderrahim E, Hedri H, et al. Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients. Saudi J Kidney Dis Transpl 2010; 21(1): 59-62.
  9. de Moraes TP, Fortes PC, Ribeiro SC, Riella MC, Pecoits-Filho R. Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients. J Bras Nefrol 2011; 33(2): 173-9.
  10. Bredie SJ, Bosch FH, Demacker PN, Stalenhoef AF, van Leusen R. Effects of peritoneal dialysis with an overnight icodextrin dwell on parameters of glucose and lipid metabolism. Perit Dial Int 2001; 21(3): 275-81.
  11. Tanaka Y, Matsuyama T, Ishikura K, Hataya H, Ikeda M, Honda M. Cholesterol ester transfer protein in children on peritoneal dialysis. Perit Dial Int 2004; 24(3): 281-6.
  12. Zhe XW, Gao F, Nie HG, Tian XK, Chen W, Liu HW, et al. Increased dialysate levels of phospholipids containing unsaturated fatty acid are associated with increased peritoneal transport rate. Am J Nephrol 2008; 28(6): 1007-13.
  13. Chaudhary K, Khanna R. Biocompatible peritoneal dialysis solutions: Do we have one? Clin J Am Soc Nephrol 2010; 5(4): 723-32.
  14. Blake PG, Bargman JM, Brimble KS, Davison SN, Hirsch D, McCormick BB, et al. Clinical practice guidelines and recommendations on peritoneal dialysis adequacy 2011. Perit Dial Int 2011; 31(2): 218-39.
  15. Monfared A, Orangpour R, Mousavian Roushan Zamir SA, Aghajani Nargesi D. Reasons of chronic renal failure in hemodialysis patients in Guilan Province. J Guilan Univ Med Sci 2003; 12(46): 76-83. [In Persian].
  16. Latha K, Varma A. Pre and post dialysis variations in serum lipid profile among end stage renal disease patients. J Clin Diagn Res 2018; 12(9): BC05-BC09.
  17. Tsubakihara Y, Nishi S, Akiba T, Hirakata H, Iseki K, Kubota M, et al. 2008 Japanese Society for Dialysis Therapy: Guidelines for renal anemia in chronic kidney disease. Ther Apher Dial 2010; 14(3): 240-75.
  18. Sniderman AD, Sloand JA, Li PK, Story K, Bargman JM. Influence of low-glucose peritoneal dialysis on serum lipids and apolipoproteins in the IMPENDIA/EDEN trials. J Clin Lipidol 2014; 8(4): 441-7.
  19. Phukan RR, Goswami RK. Unusual dyslipidemia in patients with chronic kidney diseases. J Clin Diagn Res 2017; 11(1): BC01-BC04.
  20. Yang WL, Zhu XY, Zhu N, Su CY, Han QF, Wang T, et al. What's the optimal lipids level for dialysis patients? A cohort study from a chinese dialysis center in a university hospital. PLoS One 2016; 11(12): e0167258.
Journal of Isfahan Medical School
Volume 38, Issue 566 - Serial Number 566
January and February 2020
Pages 121-128

Files

History

  • Receive Date: 20 August 2019
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics