EFFECT OF HAEMODIALYSIS AND FREQUENCY OF DIALYSIS SESSIONS ON SERUM LIPIDS AND BIOCHEMICAL PROFILE IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Keywords:
Uremia, CKD, Renal FailureAbstract
Background: Different phenomenon such as loss or accumulation of various substances and dysregulation or alteration in number of metabolic pathways are responsible for aetiology and pathogenesis of chronic changes in chronic kidney disease (CKD). Haemodialysis or renal replacement therapy (RRT) does not correct the dyslipidemia of uraemia but may modify it. The objective of this study was to see the effects of haemodialysis and frequency of dialysis sessions on dyslipidemia and various biochemical markers in patients with CKD. Methods: This was a hospital based cross-sectional observational study conducted in Dialysis Unit of Ayub Teaching Hospital, Abbottabad. In our study renal functions and lipid profile of 30 healthy subjects as control group were compared with 56 cases of CKD undergoing haemodialysis with a frequency of 1, 4, 8, or 12 per moth. Serum lipid profile, renal function tests, serum and urinary albumin was estimated for both the groups. They were further analysed for serum markers before dialysis (pre-HD) and post dialysis, six months (post-HD). Statistical analysis was performed using SPSS-17. Results: Thirty (54%) subjects were males and 26 (46%) were females. The mean age of the patients was 45.48±14.78 years as against mean age of controls (46.78±13.95 years). Urea and creatinine were raised, and anaemia, hypocalcemia, hypoalbuminemia, hyponatremia, and hyperkalemia were observed. A significant elevation in serum total cholesterol, triglycerides, LDL and VLDL-C was seen. There was a reduction in HDL-C in pre-dialysis patients compared to controls. The difference between pre-HD and post-HD groups was unremarkable except for the serum potassium, chloride, urea, creatinine, total cholesterol, triglycerides and HDL-C. The effect of frequency of dialysis sessions was also not statistically significant. Conclusion: Regular treatment with dialysis may partially compensate for loss of renal function and decrease the accumulation of toxic metabolites, but cannot revert the overall physiological deficit.
Pak J Physiol 2018;14(1):3–6
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2. Lodh M, Lal S, Goswami B, Karmakar P, Parida AK. Dyslipidemia in chronic renal failure: Cause or effect? Asian J Med Sci 2016;7(5):42–6.
3. Vaziri ND, Norris K. Lipid disorders and their relevance to outcomes in chronic kidney disease. Blood Purif 2011;31:189–96.
4. Attman PO, Samuelsson O, Johansson AC, Moberly JB, Alaupovic P. Dialysis modalities and dyslipidemia. Kidney Int Suppl 2003;84:S110–2.
5. Cibulka R, Racek J. Metabolic disorders in patients with chronic kidney failure. Physiol Res 2007;56:697–705.
6. Kaysen GA. Dyslipidemia in chronic kidney disease: Causes and consequences. Kidney Int 2006;70:S55–8.
7. Vaziri ND. Dyslipidemia of chronic renal failure: the nature, mechanisms, and potential consequences. Am J Renal Physiol 2006;290:262–72.
8. Cibulka R, Racek J, Vesela E. The importance of L-carnitine in patients with chronic renal failure treated with hemodialysis. Vnitr Lek 2005;51:1108–13.
9. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National kidney foundation practice guidelines for chronic kidney disease: evaluation, classification and stratification. Ann Intern Med 2003;139(2):137–47.
10. Salgado JV, Neves FA, Bastos MG, França AK, Brito DJ, Santos EM, et al. Monitoring renal function: measured and estimated glomerular filtration rates-a review. Braz J Med Biol Res 2010;43(6):528–36.
11. Addabbo F, Mallamaci F, Leonardis D, Tripepi R, Tripepi G, Goligorsky MS, et al. Searching for biomarker patterns characterizing carotid atherosclerotic burden in patients with reduced renal function. Nephrol Dial Transplant 2007;22:3521–6.
12. Sreenivasulu U, Bhagyamma SN, Anuradha R. Study of serum electrolyte changes in end stage renal disease patients before and after hemodialysis sessions: a hospital based study. Sch Acad J Biosci 2016;4(3B):283–7.
13. Shankalia DM, Tanna AC. Role of hemodialysis in renal failure to correct biochemical parameters. Indian J Appl Res 2013;3(6):414–6.
14. Varan HI, Dursum B, Dursum E, Ozben T, Suleymanlar G. Acute effects of hemodialysis on oxidative stress parameters in chronic uremic patients: comparision of two dialysis membranes. Int J Nephrol Renovasc Dis 2010;3:39–45.
15. Akdag I, Yilmaz Y, Kahvecioglu S, Bolca N, Ercan I, Ersoy A, et al. Clinical value of the malnutrition-inflammation-atherosclerosis syndrome for long-term prediction of cardiovascular mortality in patients with end-stage renal disease: A 5-year prospective study. Nephron Clin Pract 2008;108:C99–105.
16. Gupta K, Mahajan R. Coronary risk factors in maintenance hemodialysis patients: Who is the culprit –hemodialysis or chronic renal failure? Int J Appl Basic Med Res 2011;1(1):11–4.
17. Jones MK, Catte A, Li L, Segrest JP. Dynamics of activation of lecithin: cholesterol acyltransferase by apolipoprotein A-I. Biochemistry 2009;48(47):11196–210.
18. Maheshwari N, Ansari MR, Darshana MS, Lal K, Ahmed K. Pattern of lipid profile in patients on maintenance hemodialysis. Saudi J Kidney Dis Transpl 2010;21:565–70.
19. Zoccali C, Kramer A, Jager KJ. Chronic kidney disease and end-stage renal disease–a review produced to contribute to the report ‘the status of health in the European Union: towards a healthier Europe’ NDT Plus 2010;3:213–24.
20. Tsimihodimos V, Dounousi E, Siamopoulos KC. Dyslipidemia in chronic kidney disease: An approach to pathogenesis and treatment. Am J Nephrol 2008;28:958–73.
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