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

Abstract

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). 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.

Keywords

• cardiovascular disease
• chronic kidney disease
• dyslipidaemia
• lipoprotein agarose gel electrophoresis