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Clinical and Experimental Nephrology

Published in:

01-04-2014 | Review Article

Serum lipids and prevention of atherosclerotic cardiovascular events in hemodialysis patients

Author: Tetsuo Shoji

Published in: Clinical and Experimental Nephrology | Issue 2/2014

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Abstract

This article reviews the relationship between serum lipids and cardiovascular disease (CVD) in hemodialysis patients. Epidemiologic studies showed a cholesterol paradox in hemodialysis patients, but it can be solved by taking protein-energy wasting and inflammation into consideration. Wasting and inflammation are the risk factors of fatality after incident CVD. Randomized controlled trials showed neutral effects of statins and statin–ezetimibe combination on CVD outcomes in dialysis patients. Current guidelines in Japan recommend that low-density lipoprotein cholesterol (LDL-C) be <120 mg/dL, or non-high-density lipoprotein cholesterol (non-HDL-C) be <150 mg/dL as an alternative target in patients with chronic kidney disease (CKD), whereas Kidney Disease: Improving Global Outcome (KDIGO) guidelines do not recommend any target lipid levels. In addition to “treat to target” and “fire and forget” guidelines, it is possible to recommend that lipid-lowering medication be initiated in certain subgroups of CKD patients. New directions of lipid research in CKD include cholesterol metabolism markers, omega-3 polyunsaturated fatty acids, and modifications of lipoproteins.

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Title: Serum lipids and prevention of atherosclerotic cardiovascular events in hemodialysis patients
Author: Tetsuo Shoji
Publication date: 01-04-2014
Publisher: Springer Japan
Published in: Clinical and Experimental Nephrology / Issue 2/2014
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI: https://doi.org/10.1007/s10157-013-0871-z

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