RENAL DYSLIPIDEMIA IN PATIENTS ON CHRONIC HAEMODIALYSIS

Abstract

Summary. Disorder of blood lipids plays an important role in atherosclerosis progress in patients ongoing chronic haemodialysis (PCHD). These patients have specific features of blood lipids with increment of triglycerides and decrement of HDL-cholesterol. Phenotype of lipid disorder in PCHD is mostly type IV according to Fredrickson (30%), and IIA and IIB fenotypes are less frequent. About 9% of lipid disorders in PCHD are isolated increase of Lp(a). Main reason of hypertriglyceridemia in PCHD is attenuated metabolism of VLDL-cholesterol because of lipoprotein lipasis inhibition. There are changes in lipoproteins quality, specially changes in LDL particle have atherogenic potential. Renal dyslipidemia treatment must be vigorous in the early stages of renal insufficiency. Treatment can be dietary measures (specially omega-3-fatty acids), statins, gemfibrozil, intravenous L-carnitin and bicarbonate given per os. Haemodialysis modifications such as highflux haemodialysis, low molecular weight heparin, vitamin E coated dialyzers and LDL-apheresis in extreme cases have important role in renal dyslipidemia treatment.