Dincer Neris, Dagel Tuncay, Afsar Baris, Covic Adrian, Ortiz Alberto, Kanbay Mehmet
Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
Division of Nephrology, Department of Medicine, Koc University School of Medicine, 34010, Istanbul, Turkey.
Int Urol Nephrol. 2019 Feb;51(2):265-277. doi: 10.1007/s11255-018-2047-y. Epub 2018 Dec 5.
The major cause of death among chronic kidney disease patients is cardiovascular diseases. Cardiovascular and kidney disease are interrelated and increase the severity of each other. Dyslipidemia is one the major causes of cardiovascular disease among chronic kidney disease patients along with diabetes and hypertension. The relationship between dyslipidemia and chronic kidney disease is reciprocal. Dyslipidemia is known to be a risk factor for chronic kidney disease and chronic kidney disease causes major alterations on lipoprotein profile, defined as the "dyslipidemic profile" of chronic kidney disease patients. Increased triglyceride, very low density lipoprotein and oxidized low density lipoprotein as well as decreased high density lipoprotein and changes in the composition of lipoproteins contribute to the "dyslipidemic profile." Treatment strategies targeting the "dyslipidemic profile" of chronic kidney disease could contribute to prevent cardiovascular diseases. Current therapy is based on the patient kidney function and consist mainly of statins. This review focuses on the effects of chronic kidney disease on the lipoprotein profile and how this may impact novel therapeutic approaches to cardiovascular risk.
慢性肾病患者的主要死因是心血管疾病。心血管疾病和肾病相互关联,会加重彼此的病情。除糖尿病和高血压外,血脂异常是慢性肾病患者心血管疾病的主要病因之一。血脂异常与慢性肾病之间的关系是相互的。血脂异常是慢性肾病的一个危险因素,而慢性肾病会导致脂蛋白谱发生重大改变,即慢性肾病患者的“血脂异常谱”。甘油三酯、极低密度脂蛋白和氧化型低密度脂蛋白升高,以及高密度脂蛋白降低和脂蛋白组成变化,共同构成了“血脂异常谱”。针对慢性肾病“血脂异常谱”的治疗策略可能有助于预防心血管疾病。目前的治疗方法基于患者的肾功能,主要包括使用他汀类药物。本综述重点关注慢性肾病对脂蛋白谱的影响,以及这可能如何影响心血管疾病风险的新型治疗方法。