Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients

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...

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Main Authors: Karra Madhu Latha, Bhongir Aparna Varma
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2018-09-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/11983/35432_230718_35432_CE[Ra]_F(Sh)_PF1(MJ_AP)_PFA(MJ_SL)_PB(MJ_AP)_PN(AP).pdf
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author Karra Madhu Latha
Bhongir Aparna Varma
author_facet Karra Madhu Latha
Bhongir Aparna Varma
author_sort Karra Madhu Latha
collection DOAJ
description 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 nonnormally 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.
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spelling doaj.art-4a5160ed5c9144c2b96a721d17ab397d2022-12-22T01:59:59ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-09-01129BC05BC0910.7860/JCDR/2018/35432.11983Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease PatientsKarra Madhu Latha0Bhongir Aparna Varma1Assistant Professor , Department of Biochemistry, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.Professor and Head, Department of Biochemistry, Mediciti Institute of Medical Sciences, Hyderabad, Telangana, India.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 nonnormally 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.https://jcdr.net/articles/PDF/11983/35432_230718_35432_CE[Ra]_F(Sh)_PF1(MJ_AP)_PFA(MJ_SL)_PB(MJ_AP)_PN(AP).pdfcardiovascular diseasechronic kidney diseasedyslipidaemialipoprotein agarose gel electrophoresis
spellingShingle Karra Madhu Latha
Bhongir Aparna Varma
Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients
Journal of Clinical and Diagnostic Research
cardiovascular disease
chronic kidney disease
dyslipidaemia
lipoprotein agarose gel electrophoresis
title Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients
title_full Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients
title_fullStr Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients
title_full_unstemmed Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients
title_short Pre and Post Dialysis Variations in Serum Lipid Profile among End Stage Renal Disease Patients
title_sort pre and post dialysis variations in serum lipid profile among end stage renal disease patients
topic cardiovascular disease
chronic kidney disease
dyslipidaemia
lipoprotein agarose gel electrophoresis
url https://jcdr.net/articles/PDF/11983/35432_230718_35432_CE[Ra]_F(Sh)_PF1(MJ_AP)_PFA(MJ_SL)_PB(MJ_AP)_PN(AP).pdf
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