Buradasınız

Anasayfa » Content

Hiperlipidemi ve Renal Hastalıklar

Hyperlipidemia and Renal Diseases

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
In patients with renal disease, particularly with nephrotic syndrome hyperlipidemia can be seen, and may lead to systemic atherosclerosis and progression of the renal disease. Several lipid abnormalities can be seen in various types of glomerular disease like, diabetic nephropathy, nephrotic syndrome, chronic renal in¬ sufficiency, transplant nephropathy, familial lecithin-cholesterol acyltransferase deficiency, arteriophepatic dysplasia. Many patients will benefit from antihyperlipidemic therapy such as probucol, niacin, bile acid sequestrants, fibric acid derivatives and usually statins. There are few controlled trials which consider the usage of statins safely in chronic kidney disease. Protective effect of statins from cardiovascular disease are demonstrated in patients who have no renal disease. In conclusion, patient with renal disease must be followed regularly for their serum lipid levels and should be treated cautiously according to the guidelines because of the negative effects of hyperlipidemia. Large randomised controlled studies are needed for safe treatment of hyperlipidemia in patients with re¬ nal disease.
Bookmark/Search this post with
Abstract (Original Language): 
Hiperlipidemi renal hastalığı olan bireylerde özellikle nefrotik sendromlu olgularda yaygın olarak izlenmektedir. Bu hastalarda artan sistemik ateroskleroza olan katkısının dışında renal hastalık ilerlemesinde de olumsuz etkiler yaratabilir. Diyabetik nefropati, nefrotik sendrom, kronik böbrek yetmezliği, transplant nefropatisi, ailevi lesitin kolesterol açil transferaz eksikliği, arteriohepatik displazi gibi çeşitli glomerüler hastalıklarda lipid anormallikleri görülebilmektedir. Birçok hasta probukol, niasin, safra asit bağlayıcıları, fibrik asit türevleri ve yaygın olarak statinler gibi lipid düşürücü ilaçlardan fayda görmektedir. Statinlerin kronik böbrek hastalığında güvenli kullanımı ile ilgili sınırlı sayıda çalışma vardır. Renal hastalığı olmayan hastalarda, lipid düşürücü tedavinin kardiyovasküler olay¬ lardan koruyucu etkisi çok belirgin olarak ortaya konulmuştur. So¬ nuç olarak renal hastalıklarda yaygın olarak rastlanan hiperlipideminin yarattığı olumsuz sonuçlardan dolayı, kronik renal hastalığı olan bireyler, lipid profili açısından düzenli takip edilmeli ve dikkat¬ li bir şekilde kılavuzlara uygun olarak tedavi edilmelidir. Kronik böbrek yetmezliği olan veya renal replasman tedavisi alan hastalar¬ da lipid düşürücü tedavinin güvenli bir şekilde kullanımına ilişkin geniş ölçekli randomize kontrollü çalışmalara gereksinim vardır.
FULL TEXT (PDF): 
PDF icon pdf_tndt_619.pdf
  • 4
181-185
  • Turkish

REFERENCES

References: 

1. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002 Dec 17;106(25):3143-421.
2. Virchow R. A more precise account of fatty metamorphosis. In: Chance F, translator. Cellular Pathology. 2nd ed. Birmingham, AL: Gryphon Edition, Ltd, 1860:342-66.
3. Moorhead JF, El Nakos M, Chan MK, Varghese Z. Lipid neph-rotoxicitiy in chronic progressive glomerular and tubulo-inters-
titial disease. Lancet 1982;2:1309-10.
4. Michael AF, Keane WF, Raij L, Vernier RL, Mauer SM. The glo-merular mesangium. Kidney Int 1980;17:141-54.
5. Grond J, Weening JJ, Elerna J. Glomerular sclerosis in nephro-
tic rats. Lab Invest 1984;51:277-85.
6. William F Keane, Bertram L Kasiske, Micheal P O'Donnel. Hyperlipidemia and the progression of renal disease Am J Clin
Nutr 1988;47:157-60.
7. Mühlfeld AS, Spencer MV. Hudkins KL et al. Hyperlipidemia aggravates renal disease in B6.ROP Os/+Mice. Kidney Int:
(2204) Vol. 66, pp, 1393-402.
8. La Rosa JC, He J, Vupputuri S. Effect of statins on risk of Co¬ronary disease;a meta-analysis of randomised controlled trials.
JAMA 1999;282:2340-6.
9. Wheeler DC, Bernard BD. Lipid abnormalities in the nephrotic syndrome; Causes, consequences and treatment. Am J Kidney Dis 1994;23:331.
10. Crew RJ, Radhakrishnan J, Appel G. Complications of the neph-rotic syndrome and their tratment. Clin Nephrol 2004;62:245.
11. Radhakrishnan J, Appel AS, Valeri A, Appel GB. The nephrotic syndrome, lipids and risk factors for cardiovascular disease. Am J Kidney Dis 1993;22:135.
12. Kronenberg F, Lingenhel A, Lhotta, K et al. Lipoprotein (a)-and low-density lipoprotein derived cholesterol in nephrotic
184
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi /Official Journal of the Turkish Society of Nephrology
Hiperlipidemi ve Renal Hastalıklar O
syndrome: Impact on lipid-lowering therapy? Kidney Int
2004;66:348.
13. Weiner DE, Sarnak MJ. Managing dyslipidemia in chronic kid¬ney disease. J Gen Intern Med 2004;19:1045.
14. Yamauchi A, Fukuhara Y, Yamamoto S, Yano F. Oncotic pres¬sure regulates gene transcriptions of albumin and apolipopro-teins in nephrosis. J Clin Invest 1961;40:490.
15. Demant T, Mathes C, Gutlich K et al. A simultaneous study of the metabolism of apolipoprotein B and albumin in nephrotic
patients. Kidney Int 1998;54:2064.
16. Warwick GL, Packard CJ, Demant T. Metabolism of apolipop-rotein B-containing lipoptoteins in subjects with nephrotic-ran-ge proteinuria. Kidney Int 1991;40:129.
17. Joles JA, Bijleved V, Van Tol A et al. Plasma triglyceride levels are higher in nephrotic than in analbuminemic rats despite a si¬milar increase in hepatic trygliceride secretion. Kidney Int
1995;47:566.
18. Laakso M, Pyorala K, Sarlund H. Lipid and Lipoprotein abnor¬malities associated with coronary artery disease in patients with insulin-dependent diabetes mellitus. Atherosclerosis 1986;6:
679-84.
19. Senti M, Romero R, Pedro Botet J et al. Lipoprotein abnormali¬ties in hyperlipidemic and normolipidemic men on hemodialy-
sis with chronic renal failure. Kidey Int 1992;41:1394.
20. Arnadottir M, Thysell H, Dallongeville J et al. Evidence that re¬duced lipoprotein lipase activity is not primary pathogenetic factor for hypertriglyceridemia in renal failure. Kidney Int 1995;48:779.
21. Akmal M, Perkins S, Kasim SE, Oh HY, Smogorzewski M,
Massry SG. Verapamil prevents chronic renal failure-induced abnormalities in lipid metabolism. Am J Kidney Dis. 1993;22
(1):158-63.
22. Akmal M, Perkins S, Kqasim SE et al. Verapamil prevents chro¬nic renal failure induced abnormalities in lipid metabolism. Am J Kidney 1993;22:158.
23. Seres DS, Strain GW, Hashim SA, Goldberg IJ, Levin NW. Imp-
rovoment of plasma lipoprotein profiles during high-flux dialy¬sis. J Am Soc Nephrol. 1993 Jan;3(7):1409-15.
24. Blankestijn PJI, Voss PF, Rabelink TJ et al. High-flux dialysis membranes improve lipid profile in chronic hemodialysis pati¬ents. J Am Soc Nephrol 1995;5:1703.
25. Levine DM, Gordon BR. Lipoprotein (a) levels in patients rece¬iving renal replacement therapy; Methodological issues and cli¬nical implications. Am J Kidney Dis 1995;26:162.
26. Maggi E, Bellazzi R, Falaschi F et al. Enhanced LDL oxidation in uremic patients: an additional mechanism for accelerated at¬herosclerosis? Kidney Int 1994;45:876.
27. Andrew Howard. Cardiovascular risk in Kidney Transplant Pa¬tient. Medscape Transplantation 2004;5(2).
28. Kasiske B, Cosio FG, Beto J et al. Clinical practice guidelines for managing dyslipidemias in kidney transplant patients: a re¬port from the Managing Dyslipidemias in Chronic Kidney Dise¬ase Working Group of the National Kidney Foundation Kidney Disease Outcomes Quality Initative. Am J Transplant 2004;4
Suppl 7:13.
29. Abtahi P, Zand MS. Management of hyperlipidemia in the stab¬le solid organ transplant recipients. Graft 2001;4:266-74.
30. Gonwa T, Mendez R, Yang HC et al, for the Prograf study grup.
Randomized trial of Tacrolimus in combination with sirolimus
or mycophenolate mofetil in kidney transplantation: results at 6 months. Transplantation 2003;75:1213-20.
31. Moore R, Thomas D, Morgan E et al. Abnormal lipid and lipop-rotein profiles following renal transplantation. Transplant Proc 1993;25:1060.
32. Massy ZA, Guijarro C, Wiederkehr MR, Ma JZ, Kasiske BL.
Chronic Allograft Rejection: immunological and nonimmunolo-
gical risk factors. Kidney Int 1996;49:518-24.
33. Chobanian AV. Hypertension antihypertensive drugs and athe¬rosclerosis. Mechanism and clinical implications. J Clin Hypertension 1986;6:679-84.
34. Baigent C, Landray M, Leaper C et al. First United Kingdom He¬arth and Renal Protection Study: biochemical efficiacy and sa¬fety of simvastatin and safety of low-dose a aspirin in chronic kidney disease. Am J Kidney Dis 2005;45:473.
35. Holdass H, Fellstrom B, Jardine AG et al. Effect of Fluvastatin on cardiac outcomes in renal transplant recipients; a multicentre randomised placebo controlled trial. Lancet 2003;361:2024-31.
36. Wanner C, Krane V, Ruf G, Marz W, Ritz E. Rationale and de¬sign of a trial improving outcome of Type 2 diabetics on hemo-dialysis. Die Deutsch Diabetes Dialysis Study Investigators. Kid¬ney Int Suppl. 1999;7:S222-6.
37. Tonelli M, Moye L, Sacks FM et al. Pravastatin for secondary prevention of cardiovascular events in persons mild chronic re¬nal insufficiency. Ann Int Med 2003;138:98-104.
38. Tonelli M, Isles C, Curhan GC et al. Effects of pravastatin on cardiovascular events in people with chronic kidney disease.
Circulation 2004;110:1557-63.
39. Tonelli M, Collins D, Robins S et al. The Veterans' affairs High-Density Lipoprotein Intervention Trial investigators. Kidney Int
2004;66:1123-30.
40. Hearth Protection Study Colloborative Group MRC/BHF hearth protection study of cholesterol lowering with simvastatin in 20536 high risks individuals: a randomised placebo-controlled
trial. Lancet 2002;360:7-22.
41. Wanner C, Krane V, Metzger T, Quaschning T. Lipid changes and statins in chronic renal insufficiency and dialysis. J Neph-
rol 2001;14(Suppl 4):76-80.
42. Rob Walker. Lipid lowering therapy in patients with chronic kidney disease. Nephrology 2005;10:S231-S4.
43. Pierides AM, Alvarez UD, Kerr DN. Clofibrate-induced muscle damage in patients with renal failure. Lancet 1975;2:1279.
44. Keilani T, Schleuter WA, Levin ML, Betlle DC. Improvement of lipid abnormalities associated with proteinuria using fosinopril an angiotensin-converting enzyme inhibitor. Ann Intern Med
1993;118:246.
45. Ravid M, Neumann L, Lishner M. Plasma lipids and the prog¬ression of nephropathy in diabetes mellitus type II: Effect of
ACE inhibitors. Kidney Int 1995;47:907.
46. Lipscombe J et al. Deterioration in renal function associated
with fibrate therapy. Clin Nephrol 2001;55:39.
47. Broeders N et al. Fibrate induced increase in blood urea and creatinin: is gemfibrozil the only innocuous agent? Nephrol Di¬al Transplant 2000;15:1993.
48. Gibbons LW, Gonzalez V, Gordon N, Grundy S. The prevalan-ce of side effects with regular and sustained release nicotinic
acid. Am J Med 1995;99:37.

Thank you for copying data from http://www.arastirmax.com