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TITLE:

LIPID PROFILE PATTERN IN A PATIENT WITH CHRONIC KIDNEY FAILURE WITH GFR <60 ML / MIN / 1.73 M2 ON MAINTENANCE HEMODIALYSIS AND CONSERVATIVE TREATMENT

AUTHORS:

Dr Haris Shakeel, Dr Muhammad Wajid, Dr Mazhar Ali

ABSTRACT:

Background: The incidence and prevalence of chronic kidney disease (CKD) is increasing worldwide and is associated with poor outcomes. The severity of CKD, along with the severity of CVD in any population, appears to be a disruptive combination for both patients and the healthcare system. Identifying CKD as a major risk factor for cardiovascular morbidity and mortality is attributed to dyslipidemia, and therefore the expectation of effective intervention to reduce premature cardiovascular mortality and progression of kidney disease to increase longevity is necessary, therefore this study may investigate the profile of lipid patient with chronic renal failure; on conservative treatment and maintenance treatment of hemodialysis. Place and Duration: This cross-sectional study was conducted at the Department of Medicine and Nephrology in Jinnah Hospital Lahore for one-year duration from March 2019 to March 2020. Methods: A cross-sectional comparative study was conducted to determine the pattern of the lipid profile in a chronic renal failure patient with GFR <60 ml / min treated conservatively compared to maintenance hemodialysis. A total of 128 study populations were selected according to the selection criteria, of which 62 patients were on maintenance dialysis (designated as group A) and 66 patients were treated conservatively with CKD (designated as group B). On average, the levels of cholesterol, LDL and triglycerides were higher in group B than in group A. On the other hand, the level of HDL was higher in group A than in group B and was statistically insignificant. At the same time, the mean LDL / HDL ratio was higher in group B than in group A. However, all these differences were statistically insignificant. Results: Among patients in group A, mean levels of triglycerides, total cholesterol, and LDL were higher in patients with stage 4 CKD than in patients with stage 5 CKD. Mean HDL levels were higher in patients with stage 5 CKD than patients with stage 4 CKD. Among patients in group B, mean triglycerides and LDL levels were higher in patients with stage IV CKD. But neither of these two differences was statistically significant. On the other hand, mean total cholesterol level was higher in patients with stage III CKD and was statistically significant (p <0.05). HDL levels were higher in stage 5 patients. But this difference was not statistically significant. In group A, the LDL / HDL ratio was higher in stage IV CKD patients and was statistically significant (p <0.05). The mean LDL / HDL ratio was the highest in stage IV CKD patients in group B and was statistically significant (p <0.05). Conclusion: Our study showed that the mean lipid profile is better in chronic kidney disease patients undergoing dialysis than in conservative patients, but it is not statistically significant as the sample size is very small. In order to conclusively comment on possible factors associated with dyslipidemia in patients with CKD, a multicenter prospective study involving a larger number of populations and providing adequate statistical power is recommended. KeyWords: chronic kidney disease, dyslipidemia, cardiovascular mortality and hemodialysis.

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