Stepanova Natalia
State Institution "O.O. Shalimov National Scientific Center of Surgery and Transplantology, National Academy of Medical Science of Ukraine", 03126 Kyiv, Ukraine.
Medical Center "Nephrocenter", 03057 Kyiv, Ukraine.
Biomedicines. 2024 Oct 17;12(10):2377. doi: 10.3390/biomedicines12102377.
Dyslipidemia is a common metabolic complication in patients undergoing peritoneal dialysis (PD) and has traditionally been viewed primarily in terms of cardiovascular risk. Current guidelines do not recommend initiating lipid-lowering therapy in dialysis patients due to insufficient evidence of its benefits on cardiovascular mortality. However, the impact of dyslipidemia in PD patients may extend beyond cardiovascular concerns, influencing PD-related outcomes such as the peritoneal ultrafiltration rate, residual kidney function, PD technique survival, and overall mortality. This review challenges the traditional perspective by discussing dyslipidemia's potential role in PD-related complications, which may account for the observed link between dyslipidemia and increased all-cause mortality in PD patients. It explores the pathophysiology of dyslipidemia in PD, the molecular mechanisms linking dyslipidemia to peritoneal membrane dysfunction, and summarizes clinical evidence supporting this hypothesis. In addition, this paper examines the potential for therapeutic strategies to manage dyslipidemia to improve peritoneal membrane function and patient outcomes. The review calls for future research to investigate dyslipidemia as a potential contributor to peritoneal membrane dysfunction and to develop targeted interventions for PD patients.
血脂异常是腹膜透析（PD）患者常见的代谢并发症，传统上主要从心血管风险的角度来看待。由于缺乏关于降脂治疗对心血管死亡率益处的充分证据，目前的指南不建议对透析患者启动降脂治疗。然而，血脂异常对PD患者的影响可能超出心血管方面，还会影响与PD相关的结局，如腹膜超滤率、残余肾功能、PD技术生存率和总体死亡率。本综述通过讨论血脂异常在PD相关并发症中的潜在作用，挑战了传统观点，这可能解释了在PD患者中观察到的血脂异常与全因死亡率增加之间的联系。它探讨了PD中血脂异常的病理生理学、将血脂异常与腹膜功能障碍联系起来的分子机制，并总结了支持这一假设的临床证据。此外，本文研究了管理血脂异常以改善腹膜功能和患者结局的治疗策略的潜力。该综述呼吁未来开展研究，将血脂异常作为腹膜功能障碍的潜在因素进行调查，并为PD患者开发有针对性的干预措施。
