lipids and chronic kidney disease clinical trials: A critical appraisal

Abstract

Cardiovascular disease is the leading cause of mortality and morbidity in patients with different stages of chronic kidney disease (CKD). The phenotypic picture of cardiovascular disease differs between those on dialysis and patients with early stages of chronic kidney disease. Whilst atherosclerotic coronary artery disease is common in the early stages of CKD, arrhythmias, congestive cardiac failure and sudden cardiac death (SCD) prevail in ESRD patients on dialysis, thus confounding interventions. Lipids profile also differs between both stages with high cholesterol levels being common at early CKD stages with relatively well-nourished patients compared to normal or low cholesterol levels in ESRD patients treated by dialysis who are usually under- or malnourished; reverse epidemiology. Lipid profiles also differ between haemodialysis and peritoneal dialysis patients; due to the high caloric content of peritoneal dialysis fluids, patient treated by this modality have higher triglycerides levels.