Mittman N, Avram M M
Division of Nephrology, Long Island College Hospital, Brooklyn, NY 11201, USA.
Semin Nephrol. 1996 May;16(3):202-13.
In summary, dyslipidemia is a common feature of various renal syndromes. Whether this perturbed lipid metabolism results in accelerated atherosclerosis and increased cerebrovascular and cardiovascular morbidity and mortality remains a subject of inquiry. Also undefined is the role of dyslipidemia in the progression of renal injury. The malnutrition that becomes a dominant morbid feature in patients on maintenance renal replacement therapy provides a caveat against aggressive intervention for modest hyperlipidemia once dialysis is instituted. Individualized assessment of end organ atherosclerotic disease and cardiovascular risk factors should form the basis for modification of the treatment plan (ie, pharmacological intervention) should nonpharmacological means prove ineffective.
总之,血脂异常是各种肾脏综合征的常见特征。这种紊乱的脂质代谢是否会导致动脉粥样硬化加速以及脑血管和心血管疾病的发病率和死亡率增加,仍是一个有待探究的问题。血脂异常在肾损伤进展中的作用也尚不明确。维持性肾脏替代治疗患者中占主导地位的营养不良特征,提醒我们一旦开始透析,应谨慎对待对轻度高脂血症的积极干预。对于终末器官动脉粥样硬化疾病和心血管危险因素的个体化评估,应作为调整治疗方案(即药物干预)的基础,前提是证明非药物手段无效。