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

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 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.PMID:34569479 | DOI:10.1159/000518456
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research

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In conclusion, female sex, smoking, and CKD stage 5D were the major risk factors for elevated BCL; additionally, statins were negatively associated with BCL in CKD.
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Therapie. 2021 Oct 24:S0040-5957(21)00211-0. doi: 10.1016/j.therap.2021.10.006. Online ahead of print.ABSTRACTBACKGROUND AND OBJECTIVES: A notable proportion of COVID-19 patients need statins for their co-existing conditions. Statins possess several anti-inflammatory properties. We have attempted to describe potential association of exposure to statins and severity of COVID symtpoms in a historical study in hospitalized COVID-19 patients.METHODS: This single-center, historical cohort study was performed in Baharloo hospital as a referral hospital for COVID-19 patients in Tehran. Patients were divided into two groups; 163 s...
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ek Chorvatova The interaction of the fluorescent probe 22-NBD-cholesterol with membranes of human peripheral blood mononuclear cells (PBMC) was tested by time- and spectrally resolved fluorescence imaging to monitor the disturbance of lipid metabolism in chronic kidney disease (CKD) and its treatment with statins. Blood samples from healthy volunteers (HV) and CKD patients, either treated or untreated with statins, were compared. Spectral imaging was done using confocal microscopy at 16 spectral channels in response to 458 nm excitation. Time-resolved imaging was achieved by time-correlated single photon counting (TCSP...
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Circulation. 2021 Oct 28. doi: 10.1161/CIRCULATIONAHA.121.055560. Online ahead of print.ABSTRACTBackground: Chronic kidney disease is associated with adverse outcomes among patients with established cardiovascular disease (CVD) or diabetes. Commonly used medications to treat CVD are less effective among patients with reduced kidney function. Methods: The Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) was a multicenter, double-blind, placebo-controlled trial that randomized statin-treated patients with elevated triglycerides (135-499 mg/dL) who had CVD or diabetes and one additional r...
Source: Circulation - Category: Cardiology Authors: Source Type: research
Am J Nephrol. 2021 Oct 27:1-9. doi: 10.1159/000519484. Online ahead of print.ABSTRACTINTRODUCTION: Guideline-directed medical therapy (GDMT) is imperative to improve cardiovascular and limb outcomes for patients with critical limb ischemia (CLI), especially amongst those at highest risk for poor outcomes, including those with comorbid chronic kidney disease (CKD). Our objective was to examine GDMT prescription rates and their variation across individual sites for patients with CLI undergoing peripheral vascular interventions (PVIs), by their comorbid CKD status.METHODS: Patients with CLI who underwent PVI (October 2016-Apr...
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
“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
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