Dyslipidemia in Chronic Kidney Disease: Contemporary Concepts and Future Therapeutic Perspectives

Background: Chronic kidney disease (CKD) is an increasingly prevalent disease state met with great morbidity and mortality primarily resulting from the high incidence of adverse cardiovascular outcomes. Therapeutic strategies in this patient population aim at controlling modifiable cardiovascular risk factors, including dyslipidemia.Summary: In this review article, we first provide the latest pathophysiologic evidence regarding the altered dyslipidemia pattern in CKD, followed by its contemporary management according to the latest guidelines. Moreover, we present the current progress regarding the emerging therapeutic strategies.Key Messages: The presence of renal impairment leads to alterations in cholesterol structure, metabolism, and reverse transport paired with increased oxidative stress. Statins remain the cornerstone of dyslipidemia management in patients with kidney dysfunction who are at risk for cardiovascular events. However, their efficacy is debatable in end-stage renal disease under renal replacement therapy. Therefore, novel treatment approaches aiming at hypertriglyceridemia, proprotein convertase subtilisin/kexin type 9, and lipoprotein(a) are under rigorous investigation while the research of gut microbiome might provide additional mechanistic and therapeutic insight.Am J Nephrol
Source: American Journal of Nephrology - Category: Neurology Source Type: research

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“In adults with dialysis-dependent chronic kidney disease (CKD [5D]), we suggest that statins or statin/ezetimibe combination not be initiated.” This recommendation statement was issued in 2013 by the Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group [1]. The quality of the supp orting evidence was graded A (high), but the strength of the recommendation (level 2) implied that “different choices will be appropriate for different patients”. Against this background, which encompasses considerable precaution, it is not unreasonable to reconsider statin initiation in dialysi s patients.
Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research
This study aimed to explore the association of LDL-C levels with adverse cardiovascular and kidney outcomes in Korean CKD patients and determine the validity of “the lower, the better” strategy for statin intake.
Source: Nutrition, Metabolism, and Cardiovascular Diseases : NMCD - Category: Nutrition Authors: Source Type: research
Int J Endocrinol. 2021 Sep 28;2021:9977840. doi: 10.1155/2021/9977840. eCollection 2021.ABSTRACTMETHODS: This prospective, observational study involved adult hypertensive patients with newly diagnosed type 2 diabetes mellitus at two university hospitals in Vietnam. The median time of follow-up was 4 years (August 2016-August 2020). The primary outcome was time to all-cause mortality.RESULTS: 246 patients were included with a mean age of 64.5 ± 10.4. 58.5% were females. 64.2% were categorized as high risk. At baseline, ischemic heart disease, dyslipidemia, and chronic kidney disease (CKD) were present in 54.9%, 67.1%...
Source: International Journal of Endocrinology - Category: Endocrinology Authors: Source Type: research
In conclusion, premature thymic involution and chronic inflammation greatly contribute to increased morbidity and mortality in CKD patients. Mechanisms are likely to be multiple and interlinked. Even when the quest to fountain of youth is a pipe dream, there are many scientific opportunities to prevent or to, at least in part, reverse CKD-related immune senescence. Further studies should precisely define most important pathways driving premature immune ageing in CKD patients and best therapeutic options to control them. Extending Life Without Extending Health: Vast Effort Directed to the Wrong Goals https://www...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Am J Nephrol. 2021 Sep 17:1-9. doi: 10.1159/000518456. Online ahead of print.ABSTRACTBACKGROUND: Chronic kidney disease (CKD) is an increasingly prevalent disease state met with great morbidity and mortality primarily resulting from the high incidence of adverse cardiovascular outcomes. Therapeutic strategies in this patient population aim at controlling modifiable cardiovascular risk factors, including dyslipidemia.SUMMARY: In this review article, we first provide the latest pathophysiologic evidence regarding the altered dyslipidemia pattern in CKD, followed by its contemporary management according to the latest guidelin...
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
ConclusionsPPI use was significantly associated with an increased risk of chronic kidney disease development compared to that with H2RA use.
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
Contrib Nephrol. 2021 Aug 24;199:1-9. doi: 10.1159/000517704. Online ahead of print.ABSTRACTClinical Background: The heart can cause kidney disease, and the kidney can cause heart disease. As an example of the first situation, we can mention dilated cardiomyopathies, which can lead to renal failure of the pre-renal type due to the state of renal hypoflow. As an example of the second situation, we can remember that renal failure is a risk factor for cardiovascular diseases, such as coronary heart disease, due to the acceleration in the process of atherosclerosis that it promotes. Epidemiology: In this chapter, we will addre...
Source: Contributions to Nephrology - Category: Urology & Nephrology Authors: Source Type: research
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