慢性腹膜透析患者血脂异常与残余肾功能之间的关联

Association between dyslipidemia and residual renal function in patients on chronic peritoneal dialysis.

作者信息

Chen H-Y, Kao T-W, Huang J-W, Tsai T-J, Wu K-D

机构信息

Department of Internal Medicine, Division of Nephrology, Far Eastern Memorial Hospital, Tapei, Taiwan.

出版信息

Clin Nephrol. 2008 Sep;70(3):233-9. doi: 10.5414/cnp70233.

DOI:10.5414/cnp70233

PMID:18793565

Abstract

BACKGROUND

Dyslipidemia and residual renal function (RRF) have a significant impact on the cardiovascular mortality in dialysis patients, but their association in patients on chronic peritoneal dialysis (PD) has not been completely studied.

METHODS

170 PD patients were divided into 2 groups based on the RRF (Group I had no RRF and Group II had RRF >0 ml/min/1.73 m2 BSA). An observational, longitudinal study was performed to elucidate the dyslipidemic state in PD patients with different levels of RRF and the association of dyslipidemia and deterioration of RRF during 3 years.

RESULTS

Patients' basic characteristics and lipid profiles at the initiation of study were similar between the groups. At the end of study, Group I patients had a lower T-CHO (p=0.001), LDL-C (p=0.018), HDL-C (p=0.05) and non-HDL-C (p=0.003) than Group II. There was a significant correlation between a change in HDL-C and the decline of RRF (r=0.177, p=0.048) and it was independent of PD duration and levels of highly sensitive C-reactive protein (r=0.233, p=0.04).

CONCLUSION

Our results clearly demonstrate the different longitudinal changes of lipid profiles in PD patients with different RRF and an association between decline of HDL-C and deterioration of RRF.

摘要

背景

血脂异常和残余肾功能（RRF）对透析患者的心血管死亡率有重大影响，但它们在慢性腹膜透析（PD）患者中的关联尚未得到充分研究。

方法

170例PD患者根据RRF分为两组（I组无RRF，II组RRF>0 ml/min/1.73 m2体表面积）。进行了一项观察性纵向研究，以阐明不同RRF水平的PD患者的血脂异常状态以及3年内血脂异常与RRF恶化之间的关联。

结果

两组患者在研究开始时的基本特征和血脂谱相似。在研究结束时，I组患者的总胆固醇（T-CHO，p=0.001）、低密度脂蛋白胆固醇（LDL-C，p=0.018）、高密度脂蛋白胆固醇（HDL-C，p=0.05）和非高密度脂蛋白胆固醇（p=0.003）均低于II组。HDL-C的变化与RRF的下降之间存在显著相关性（r=0.177，p=0.048），且独立于PD持续时间和高敏C反应蛋白水平（r=0.233，p=0.04）。