Dyslipidemia in dialysis

Abstract

Cardiovascular (CV) disease is the leading cause of death in dialysis patients. Traditional CV risk factors aggregate in this population as well as an abundance of novel risk factors unique to dialysis population. Dyslipidemia is related to increased CV risk in the general population. However, recent randomized trials showed no clear benefit of treating dyslipidemia in hemodialysis patients with a statin. Several hypotheses have been put forward to account for these discouraging results, including differences in atherosclerotic plaque composition, qualitative and quantitative changes in lipid profiles of hemodialysis patients, and increased frequency of sudden deaths in this population, among others. Dialysis mode, namely HD or peritoneal dialysis (PD), also lead to some particular changes in the lipid and lipoprotein profiles. PD patients generally have a more atherogenic lipid profile compared with their HD counterparts. Modifications in some parameters of HD or PD along with pharmacologic therapy, mainly statins, constitute the current therapeutic armamentarium against dyslipidemia in dialysis patients. Future randomized controlled trials taking into account the particular characteristics of dialysis dyslipidemia are needed for evidence-based answers in this currently controversial topic.