Sibi N. S1, Rajesh Kumar P2
BACKGROUND
Chronic kidney disease is a worldwide public health problem. The adverse outcomes of chronic kidney disease, such as kidney failure, cardiovascular disease and premature death can be prevented or delayed. Chronic renal disease is accompanied by characteristic abnormalities of lipid metabolism. High cholesterol and triglyceride plasma levels have been demonstrated to be independent risk factors for progression of renal disease in humans. The pattern of lipid abnormalities in chronic renal disease patients in Kerala, India, has not been studied.
The primary aim of the study is to describe the pattern of lipid profile in nondiabetic chronic kidney disease patients. The secondary objective is to determine the proportion of patients with nondiabetic chronic kidney disease who have lipid abnormalities.
MATERIALS AND METHODS
Our study is a cross-sectional study conducted in Department of Internal Medicine, Government Medical College, Trivandrum, during the time period of 22-08-2014 to 22-08-2015. The study was conducted after clearance from Institutional Ethics Committee and written informed consent was obtained from all study participants. 134 nondiabetic patients who were diagnosed to have Chronic Kidney disease (CKD) according to KDOQI and NKF criteria with a GFR <60 admitted in general medicine ward were included in the study. Patients of age <20 yrs. patients who are known case of diabetes mellitus or hypothyroidism, patients who had a history of any acute coronary event and patients who were already on hypolipidemic agents were excluded. Data was collected in structured data collection proforma, which included history, physical examination and relevant blood investigations, fasting lipid profile, fasting and postprandial blood sugar estimation, HbA1c and serum creatinine levels. EGFR is calculated using the Cockroft-Gault equation. Creatinine clearance (CrCl) = ((140 - age) x (weight in kg) x (0.85 for female)) ÷ (72 x serum creatinine). Data was entered in Microsoft excel® and statistical analysis was done using SPSS® Version 16 and Epi-Info® Version 7. Proportions and 95% CI were calculated between group comparison of means was done using one way ANOVA.
RESULTS
134 patients with mean age of 62 ± 11.3 years were enrolled of which 63.4% were males. Stage III CKD were seen in 30%, stage IV and V CKD in 35% of study subjects. The commonest aetiology for CKD was hypertension. 91 (67.9%) study subjects had dyslipidaemia. Age group >70 years showed significantly higher serum creatinine value and lower EGFR. Significantly, higher values of Total Cholesterol (TC), Low-Density Lipoproteins (LDL), Triglycerides (TG) and Very Low-Density Lipoproteins (VLDL) were seen in the age group >70 years and in stage V CKD compared to other groups.
CONCLUSION
Dyslipidaemia is common in nondiabetic CKD patients (67.91%). Higher stages of CKD were associated with more dyslipidaemia.
