Comparison of lipid measures and risk stratification among end-stage renal disease patients.

BACKGROUND

Abnormal lipid profiles are associated with end-stage renal disease (ESRD) which significantly contributes to an accelerated progression of coronary artery disease. The purpose of this study was to examine the relationships between cholesterol measures and differences in risk stratification when using National Cholesterol Education Program, Adult Treatment Panel, Third Report (ATP-III) guidelines, compared with cholesterol particle number and size in ESRD patients.

METHODS

Lipid profiles were conducted on 541 ESRD patients who were chronic hemodialysis patients. Lipid profiles were measured using gel electrophoresis and their particle size and concentration measured using nuclear magnetic resonance (NMR) spectroscopy. Correlations and risk stratification were compared between each lipid measure.

RESULTS

The findings suggest that low-density lipoprotein (LDL) size does not correlate well with LDL cholesterol and LDL particle number. The findings also suggest a "disconnect" between traditional lipid measures and cholesterol concentration and size when using ATP-III guidelines for risk stratification.

CONCLUSIONS

The cholesterol risk designation variances between risk stratification guidelines and the relationships established through Pearson correlations, as illustrated within this patient pool, reveal the complex differences between measures of coronary artery disease risk. These additional patients considered at-risk using NMR technology may help to identify more patients at need for intervention and treatment.