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World J Nephrol. Feb 6, 2015; 4(1): 83-91
Published online Feb 6, 2015. doi: 10.5527/wjn.v4.i1.83
Lipid abnormalities in kidney disease and management strategies
Vishwam Pandya, Akhilesh Rao, Kunal Chaudhary
Vishwam Pandya, Akhilesh Rao, Kunal Chaudhary, Division of Nephrology, University of Missouri Health Science Center, Columbia, MO 65212, United States
Kunal Chaudhary, Nephrology Section, Harry S Truman Veterans’ Hospital, Columbia, MO 65212, United States
Author contributions: Pandya V, Rao A and Chaudhary K contributed to the structure, content and discussion of this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kunal Chaudhary, MD, FACP, FASN, FASH, Professor of Medicine, Division of Nephrology, University of Missouri Health Science Center, One Hospital Drive, DC043.00, Columbia, MO 65212, United States. chaudharyk@health.missouri.edu
Telephone: +1-573-8847992 Fax: +1-573-8844820
Received: July 30, 2014
Peer-review started: July 31, 2014
First decision: September 16, 2014
Revised: October 22, 2014
Accepted: October 31, 2014
Article in press: November 3, 2014
Published online: February 6, 2015
Abstract

Patients with kidney diseases continue to experience significant cardiovascular disease (CVD) morbidity and mortality. Although there are many important risk factors playing a role in the pathogenesis of CVD in chronic kidney disease (CKD) patients, dyslipidemia (elevated triglycerides, elevated oxidized low-density lipoprotein and low/dysfunctional low high-density) represents one of the modifiable risk factors. Renal failure patients have unique lipid abnormalities which not only have complex role in pathogenesis of CVD but also cause relative resistance to usual interventions. Most of the randomized trials have been in hemodialysis population and data from CKD non-dialysis, peritoneal dialysis and renal transplant populations is extremely limited. Compared to general population, evidence of mortality benefit of lipid lowering medications in CKD population is scarce. Future research should be directed towards establishing long term benefits and side effects of lipid lowering medications, through randomized trials, in CKD population.

Keywords: Chronic kidney disease, Dyslipidemia, Statins, Cardiovascular disease, Renal transplant recipients, Hemodialysis, Peritoneal dialysis

Core tip: Burden of cardiovascular disease and dyslipidemia continues to be high among patients with kidney diseases. Our review includes unique lipid abnormalities specifically affecting patients with kidney diseases. We have included comprehensive review of the latest evidence of the dyslipidemia treatment for each sub-group [i.e., chronic kidney disease (CKD) not on dialysis, CKD on dialysis and Kidney transplant recipients] and current guidelines from Kidney Diseases: Improving Global Outcomes.