Emergency Department, Cantonal Hospital, Neuchâtel, Switzerland.
J Nephrol. 2012 Jul-Aug;25(4):460-72. doi: 10.5301/jn.5000154.
Hyperlipidemia in the general population is strongly associated with an increased incidence of major adverse cardiovascular (CV) events (MACE). It is well established that HMG-CoA reductase inhibitors (statins) reduce CV and all-cause mortality in the general population, as well as in patients with CV disease (CVD). However, such a finding has not been definitively confirmed in patients with chronic kidney disease (CKD). Given that CV risk gradually increases with increasing stages of CKD (and is even higher in dialysis patients), it is of major relevance and importance to identify whether CKD patients might also benefit from alteration of lipid fractions, and how this might best be achieved. Bearing in mind that animal model and preclinical evidence suggests dyslipidemia might also be a factor promoting worsening renal function, it could legitimately be asked whether treating it may also therefore have a nephroprotective effect.
在普通人群中，高脂血症与主要不良心血管（CV）事件（MACE）的发生率增加密切相关。众所周知，羟甲基戊二酰辅酶 A 还原酶抑制剂（他汀类药物）可降低普通人群以及患有心血管疾病（CVD）患者的 CV 和全因死亡率。然而，在慢性肾脏病（CKD）患者中，尚未明确证实这一发现。鉴于 CV 风险随着 CKD 阶段的增加而逐渐增加（甚至在透析患者中更高），因此确定 CKD 患者是否也可能受益于脂质分数的改变，以及如何最好地实现这一目标，具有重要意义。鉴于动物模型和临床前证据表明，血脂异常也可能是促进肾功能恶化的一个因素，可以合理地提出，治疗血脂异常是否也具有肾脏保护作用。
