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透析患者的血脂异常

Dyslipidemia in dialysis patients.

作者信息

Mitwalli Ahmed H, Alam Awatif A, Al Wakeel Jamal S, Isnani Arthur C

机构信息

Division of Nephorology, Department of Medicine, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia.

出版信息

Saudi J Kidney Dis Transpl. 2011 Jul;22(4):689-94.

Abstract

In order to evaluate the lipid profiles of dialysis patients, we retrospectively reviewed all the chronic kidney disease (CKD) patients on chronic hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD), followed up between June 2004 and May 2005, in two tertiary hospitals in Riyadh, Saudi Arabia. There were 380 patients including 206 (54.2%) females and the mean age of the patients was 45.9 ± 15.8 years. The mean dialysis duration was 65.0 ± 58.3 months. Diabetes was present in 97 (25.5%) of the patients and hypertension in 84 (22.1%). Younger patients had more disturbed lipid profile than elderly patients, and females had higher lipid values than males. The CAPD patients had worse lipid profile than those on HD, irrespective of age, sex and duration of dialysis. The presence of diabetes, hypertension, smoking and cardiovascular disease (CVD) all contributed to the worsening of lipid profiles of our patients. Dialysis patients showed improvement in lipid profile initially followed by gradual deterioration. We conclude that dyslipidemia, which increases the risk of CVD by increasing atherogenesis, progresses over time in dialysis patients and becomes worse in CAPD patients.

摘要

为了评估透析患者的血脂状况,我们回顾性分析了2004年6月至2005年5月期间在沙特阿拉伯利雅得的两家三级医院接受慢性血液透析(HD)或持续性非卧床腹膜透析(CAPD)治疗的所有慢性肾脏病(CKD)患者。共有380例患者,其中女性206例(54.2%),患者平均年龄为45.9±15.8岁。平均透析时间为65.0±58.3个月。97例(25.5%)患者患有糖尿病,84例(22.1%)患者患有高血压。年轻患者的血脂状况比老年患者更紊乱,女性的血脂值高于男性。无论年龄、性别和透析时间如何,CAPD患者的血脂状况都比HD患者差。糖尿病、高血压、吸烟和心血管疾病(CVD)的存在均导致我们的患者血脂状况恶化。透析患者最初血脂状况有所改善,随后逐渐恶化。我们得出结论,血脂异常通过增加动脉粥样硬化的发生风险,在透析患者中随时间推移而进展,在CAPD患者中更为严重。

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