TY - JOUR
T1 - Lipid management in patients with chronic kidney disease
AU - Ferro, Charles J
AU - Mark, Patrick B
AU - Kanbay, Mehmet
AU - Sarafidis, Pantelis
AU - Heine, Gunnar H
AU - Rossignol, Patrick
AU - Massy, Ziad A
AU - Mallamaci, Francesca
AU - Valdivielso, Jose M
AU - Malyszko, Jolanta
AU - Verhaar, Marianne C
AU - Ekart, Robert
AU - Vanholder, Raymond
AU - London, Gerard
AU - Ortiz, Alberto
AU - Zoccali, Carmine
N1 - Funding Information:
A.O.’s work was supported by Spanish Government ISCIII FEDER funds (PI16/02057, ISCIII-RETIC REDinREN RD16/0009) and Community of Madrid (B2017/BMD-3686 CIFRA2-CM). P.R.’s work is supported by a public grant overseen by the French National Research Agency (ANR) as part of the second “Investissements d’Avenir” program FIGHT-HF (reference: ANR-15-RHU-0004) and by the French PIA project “Lorraine Université d’Excellence”, reference ANR-15-IDEX-04-LUE.
Publisher Copyright:
© 2018, Springer Nature Limited.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - An increased risk of cardiovascular disease, independent of conventional risk factors, is present even at minor levels of renal impairment and is highest in patients with end-stage renal disease (ESRD) requiring dialysis. Renal dysfunction changes the level, composition and quality of blood lipids in favour of a more atherogenic profile. Patients with advanced chronic kidney disease (CKD) or ESRD have a characteristic lipid pattern of hypertriglyceridaemia and low HDL cholesterol levels but normal LDL cholesterol levels. In the general population, a clear relationship exists between LDL cholesterol and major atherosclerotic events. However, in patients with ESRD, LDL cholesterol shows a negative association with these outcomes at below average LDL cholesterol levels and a flat or weakly positive association with mortality at higher LDL cholesterol levels. Overall, the available data suggest that lowering of LDL cholesterol is beneficial for prevention of major atherosclerotic events in patients with CKD and in kidney transplant recipients but is not beneficial in patients requiring dialysis. The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Lipid Management in CKD provides simple recommendations for the management of dyslipidaemia in patients with CKD and ESRD. However, emerging data and novel lipid-lowering therapies warrant some reappraisal of these recommendations.
AB - An increased risk of cardiovascular disease, independent of conventional risk factors, is present even at minor levels of renal impairment and is highest in patients with end-stage renal disease (ESRD) requiring dialysis. Renal dysfunction changes the level, composition and quality of blood lipids in favour of a more atherogenic profile. Patients with advanced chronic kidney disease (CKD) or ESRD have a characteristic lipid pattern of hypertriglyceridaemia and low HDL cholesterol levels but normal LDL cholesterol levels. In the general population, a clear relationship exists between LDL cholesterol and major atherosclerotic events. However, in patients with ESRD, LDL cholesterol shows a negative association with these outcomes at below average LDL cholesterol levels and a flat or weakly positive association with mortality at higher LDL cholesterol levels. Overall, the available data suggest that lowering of LDL cholesterol is beneficial for prevention of major atherosclerotic events in patients with CKD and in kidney transplant recipients but is not beneficial in patients requiring dialysis. The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Lipid Management in CKD provides simple recommendations for the management of dyslipidaemia in patients with CKD and ESRD. However, emerging data and novel lipid-lowering therapies warrant some reappraisal of these recommendations.
KW - Journal Article
KW - Review
KW - Glomerular Filtration Rate
KW - Proprotein Convertase 9/antagonists & inhibitors
KW - Fibric Acids/therapeutic use
KW - Humans
KW - Lipid Metabolism
KW - Renal Insufficiency, Chronic/complications
KW - Cholesterol Ester Transfer Proteins/antagonists & inhibitors
KW - Biological Products/therapeutic use
KW - Drug Discovery
KW - Fatty Acids, Omega-3/therapeutic use
KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
KW - Dyslipidemias/blood
KW - Cardiovascular Diseases/etiology
KW - Practice Guidelines as Topic
UR - http://www.scopus.com/inward/record.url?scp=85055507915&partnerID=8YFLogxK
U2 - 10.1038/s41581-018-0072-9
DO - 10.1038/s41581-018-0072-9
M3 - Review article
C2 - 30361677
SN - 1759-5061
VL - 14
SP - 727
EP - 749
JO - Nature Reviews. Nephrology
JF - Nature Reviews. Nephrology
IS - 12
ER -