ASSESSMENT OF LIPID DYSFUNCTION IN PATIENTS ON MAINTENANCE HAEMODIALYSIS

Ashfaq Altaf, Abdul Halim, Dilshad Ahmad Khan, Muhammad Khalid, Fatima -Tuz- Zuhra, Imran Saif

Abstract


Background: Dyslipidaemia is a major risk factor of cardiovascular disease in patients on
maintenance haemodialysis. Both increased and decreased levels of cholesterol are associated
with increased cardiovascular mortality in haemodialysis patients. Objective: To assess the lipid
dysfunction among patients on maintenance haemodialysis in a nephrology unit at Rawalpindi as
compared with healthy individuals. Methodology: A descriptive comparative study was carried
out in a nephrology unit at Rawalpindi, Pakistan. A total of 140 subjects were included consisting
of 70 patients on maintenance haemodialysis (MHD) and 70 healthy controls. Body mass index
(BMI) was measured according to WHO guidelines. Serum total cholesterol (TC), triglycerides
(TG) and high-density lipoprotein cholesterol (HDL-C) were assayed on chemistry analyser.
Low-density lipoprotein cholesterol (LDL-C) was calculated by Friedwald equation. Result:
MHD patients had significantly lower BMI, mean (SD) 20.07(3.66) as compared with the controls
22.88(3.97) kg/m2 (p<0.001). The lipid profile among MHD patients and controls are given as
mean (SD): (a) Total Cholesterol 3.84(1.06) vs 4.65(0.97) (p<0.001), (b) LDL-C 2.21(0.77) vs
2.93(0.71) (p<0.001), (c) HDL-C 0.95(0.166) vs 0.97(0.138) (p=NS), (d) Non HDL 2.88(0.95) vs
3.67(0.88) (p<0.0001), (e) Triglycerides 1.68(1.09) vs 1.69(0.86) (p=NS). The most common
abnormality observed in haemodialysis patients was low HDL-C (81%) followed by increased
Non-HDL-C (23%) and increased serum triglycerides (19%). Conclusion: It is concluded that
our patients on maintenance haemodialysis have significantly low BMI, total Cholesterol, LDL-C
and Non-HDL-C depicting malnutrition leading to inflammation, accelerated atherosclerosis
process and cardiovascular complications.
Key words: total Cholesterol, lipoproteins, BMI, haemodialysis, cardiovascular disease

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