Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients
BC05-BC09
Correspondence
Dr. Karra Madhu Latha,
Flat. No. A3-505, Sadbhavana Township, APRSCL Rajiv Swagruha, Pocharam Village,
Ghatkesar Mandal, Hyderabad-500088, Telangana, India.
E-mail: madhu.harini123@gmail.com
Introduction: Chronic Kidney Disease (CKD) is a devastating disease and 50% of CKD patients die from Cardiovascular Disease (CVD) rather than End Stage Renal Disease (ESRD). Dyslipidaemia is a major contributor of CVD in these patients. The exact effect of Renal Dialysis (RD) on lipid parameters in ESRD is not clearly elucidated.
Aim: To assess the variations in serum lipid profile and study the pattern of lipoproteins by agarose gel electrophoresis before and after RD.
Materials and Methods: In this case-control study, 30 ESRD patients (15 male and 15 female) receiving maintenance renal dialysis were taken as cases and 30 age and sex matched healthy individuals were recruited as controls. Lipid profile parameters were estimated in Siemens automated analyser. Lipoprotein electrophoresis was done on Sebia Semi automated analyser. The data were analysed using GraphPad prism. Student’s t-test for normally distributed data, Mann-Whitney U test for non-normally distributed data and ANOVA for comparison of more than two groups was done. A p-value <0.05 was considered statistically significant.
Results: In ESRD cases there was a significant increase (p <0.001) in Total Cholesterol (TC), Low Density Lipoprotein Cholesterol (LDL-C), High Density Lipoprotein Cholesterol (HDL-C) after RD compared to the values before RD (151.4±38.92 versus 183±57.18 mg/dL; 75.3±24.66 mg/dL versus 84.23±29.74; 31.9±9.74 mg/dL versus 35.57±12.49 mg/dL); respectively. Triglycerides (TG) and Very Low Density Lipoprotein (VLDL) values decreased after RD compared to the values before RD (123.6±50 versus 121.4±49.26; 24.73±10 versus 24.29±9.85); (p>0.05). Fractionation of lipoproteins reveals a significant increase in lipoprotein a {Lp(a)} as compared to controls (21.20±17.46 versus 12.38±10.63, p<0.05). The values of alpha and beta lipoproteins in electrophoresis didn’t correlate well with the values obtained from automated enzymatic lipoprotein measurements in ESRD cases after dialysis (r=0.22, p=0.18).
Conclusion: There is a remarkable increase in atherosclerotic risk after RD noted due to significant increase in TC, LDL-C and Lp(a) which might increase the risk of CVD in RD subjects.