COMPARISON OF DIURNAL INDEX AND LIPID PARAMETERS FROM NORMAL INDIVIDUALS AND PATIENTS Of DIABETIS WITH CHRONIC KIDNEY DISEASE
Main Article Content
Keywords
CKD, Dyslipidemia, CVD, Ambulatory blood pressure monitoring
Abstract
Chronic kidney disease (CKD) heightens the risk of cardiovascular complications and often linked with a non-dipping blood pressure (BP) pattern. We assessed 24 hour ambulatory blood pressure, and lipid profile of diabetic patients suffering from CKD . To determine the frequency of associated risk factors in diabetic CKD patients, A cross-sectional research design was employed at ERA’s Lucknow Medical College and Hospital for this study. We recruited 184 patients with diabetic CKD Patients (mean age, 60.9±12.0 years). After adjusting for age and sex, hypertension and lipid profile showed a significant association with CKD. Levels of triglycerides (TG), very-low-density lipoprotein (VLDL), total cholesterol, and low-density lipoprotein (LDL) were elevated in CKD cases in comparison to normal individuals, whereas high-density lipoprotein (HDL) and estimated glomerular filtration rate (eGFR) were notably lower in the cases. On analysis of data, HDL level was decreased in CKD patients and correlation was statistically significant (p<0.001).LDL level was found to be higher in cases than in CKD patients, this correlation was also significant with p value less than 0.001. In the cases total cholesterol level was found to be elevated that is in CKD patients and the association was scientifically significant (p<0.001). In cases the level of triglceride was also more that are in CKD patients and the association was significantly correlated (p<0.001).In addition, Dipping was maximum in control groups (70.7%) while non-dipping was maximum in the case group (75%). A significant association of dipping was found with the case (p<0.001).
References
2. Charles RH, Terry AJ. Managing dyslipidemia in chronic kidney disease. J Am Coll Cardiol. 2008;51:2375–2384.
3. Ahmed MH, Khalil AA. Ezetimibe as a potential treatment for dyslipidemia associated with chronic renal failure and renal transplant. Saudi J Kidney Dis Transplant. 2010;21:1021–1029.
4. Balode AA, Khan ZH. Serum lipid profile in chronic kidney disease patients on haemodialysis. IJAR. 2013;3:20–22.
5. Burmeister JE, Mosmann CB, Veridiana Borges Costa VB, et al. Prevalence of cardiovascular risk factors in hemodialysis patients – the CORDIAL study. Arq Bras Cardiol. 2014;102:473–480.
6. Kwan BCH, Kronenberg F, Beddhu S, Cheung AK. Lipoprotein Metabolism and lipid management in chronic kidney disease. J Am Soc Nephrol. 2007;18:1246–1261.
7. Chen S-C, Hung C-C, Kuo M-C, et al. Association of dyslipidemia with renal outcomes in chronic kidney disease. PLoS One. 2013;8:e55643.
8. Cases A, Coll E. Dyslipidemia and the progression of renal disease in chronic renal failure patients. Kidney Int Suppl. 2005;(99):S87–S93.
9. Weiner DE, Sarnak MJ. Managing dyslipidemia in chronic kidney disease. J Gen Intern Med. 2004;19:1045–1052.
10. Shurraw S, Tonelli M. Statins for treatment of dyslipidemia in chronic kidney disease. Perit Dial Int. 2006;26:523–539.
11. Wanner C, Ritz E. Reducing lipids for CV protection in CKD patients—current evidence. Kidney Int. 2008;74:24–28.
12. Tsimihodimos V, Mitrogianni Z, Elisaf M. Dyslipidemia associated with chronic kidney disease. Open Cardiovasc Med J. 2011;5:41–48.
13. Piecha G, Adamczak M, Ritz E. Dyslipidemia in chronic kidney disease. Pol Arch Med Wewn. 2009;119:487–492.
14. Molitch ME. Management of dyslipidemias in patients with diabetes and chronic kidney disease. Clin J Am Soc Nephrol. 2006;1:1090–1099.
15. Kimura H, Miyazaki R, Imura T, Masunaga S, Suzuki S, Gejyo F, Yoshida H. Hepatic lipase mutation may reduce vascular disease prevalence in hemodialysis patients with high CETP levels. Kidney Int. 2003;64:1829–1837.
16. Shoji T, Nishizawa Y, Kawagishi T, et al. Atherogenic lipoprotein changes in the absence of hyperlipidemia in patients with chronic renal failure treated by hemodialysis. Atherosclerosis. 1997;131:229–236.
17. Kronenberg F, Lingenhel A, Neyer U, et al. Prevalence of dyslipidemic risk factors in hemodialysis and CAPD patients. Kidney Int Suppl. 2003;84:113–116.
18. Santos, H. O., Earnest, C. P., Tinsley, G. M., Izidoro, L. F., & Macedo, R. C. (2020). Small dense low-density lipoprotein-cholesterol (sdLDL-C): Analysis, effects on cardiovascular endpoints and dietary strategies. Progress in cardiovascular diseases, 63(4), 503-509.
19. Rizvi, A. A., Stoian, A. P., Janez, A., & Rizzo, M. (2021). Lipoproteins and cardiovascular disease: an update on the clinical significance of atherogenic small, dense LDL and new therapeutical options. Biomedicines, 9(11), 1579.
20. Deprince, A., Haas, J. T., & Staels, B. (2020). Dysregulated lipid metabolism links NAFLD to cardiovascular disease. Molecular metabolism, 42, 101092.
21. Mikolašević I, Lukenda V, Sladoje-Martinović B, et al. Metabolic complications after solid organ transplantation. Medicina Fluminensis. 2014;50:61–66.
22. Kahwaji JM, Dudek RR. How can we manage hyperlipidemia and avoid rhabdomyolysis in transplant patients? Perm J. 2006;10:26–28.
23. Karamanakos, G., Kokkinos, A., Dalamaga, M., & Liatis, S. (2022). Highlighting the Role of Obesity and Insulin Resistance in Type 1 Diabetes and Its Associated Cardiometabolic Complications. Current Obesity Reports, 1-23.
24. Dabravolski, S. A., Sukhorukov, V. N., Kalmykov, V. A., Grechko, A. V., Shakhpazyan, N. K., & Orekhov, A. N. (2022). The role of KLF2 in the regulation of atherosclerosis development and potential use of KLF2-targeted therapy. Biomedicines, 10(2), 254.
25. Moorhead JF, Chan MK, El-Nahas M, et al. Lipid nephrotoxicity in chronic progressive glomerular and tubulo-interstitial disease. Lancet. 1982;2:1309–1311.
26. Sugasini, D., Yang, P., Ng, D., Sumeet, A. K., Vitali, C., Daniel, J. R., & Subbaiah, P.V. (2021). Potential role of hepatic lipase in the accretion of docosahexaenoic acid (DHA) by the brain. Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids, 1866(10), 159002.
27. Harper CR, Jacobson TA. Managing dyslipidemia in chronic kidney disease. J Am Coll Cardiol. 2008;51:2375–2384.
28. Gluba-Brzózka, A., Rysz, J., Franczyk, B., & Banach, M. (2022). Dyslipidemia and Diabetes. In Diabetes and Kidney Disease (pp. 341-360). Springer, Cham.
29. Rohatgi, A., Westerterp, M., Von Eckardstein, A., Remaley, A., & Rye, K. A. (2021). HDL in the 21st century: a multifunctional roadmap for future HDL research. Circulation, 143(23), 2293-2309.
30. Mao, W., Ding, X., Ding, Y., Cao, B., Fu, C., Kuehn, B., ... & Zeng, M. (2022). Evaluation of interstitial fibrosis in chronic kidney disease by multiparametric functional MRI and histopathologic analysis. European Radiology, 1-10.
31. Sethna, C. B., Grossman, L. G., Dhanantwari, P., Gurusinghe, S., Laney, N., Frank, R., & Meyers, K. E. (2020). Restoration of nocturnal blood pressure dip and reduction of nocturnal blood pressure with evening anti‐hypertensive medication administration in pediatric kidney transplant recipients: a pilot randomized clinical trial. Pediatric Transplantation, 24(8), e13854.
32. Omboni, S., Posokhov, I., Parati, G., Arystan, A., Tan, I., Barkan, V., ... & VASOTENS Registry Study Group. (2020). Variable association of 24-h peripheral and central hemodynamics and stiffness with hypertension-mediated organ damage: the VASOTENS Registry. Journal of Hypertension, 38(4), 701-715.
33. Kario, K., Ferdinand, K. C., & O'Keefe, J. H. (2020). Control of 24-hour blood pressure with SGLT2 inhibitors to prevent cardiovascular disease. Progress in Cardiovascular Diseases, 63(3), 249-262.
34. Kario, K., Weber, M. A., Mahfoud, F., Kandzari, D. E., Schmieder, R. E., Kirtane, A. J., ... & Tsioufis, K. P. (2019). Changes in 24-hour patterns of blood pressure in hypertension following renal denervation therapy. Hypertension, 74(2), 244-249.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Syed Tahseen Raza
Assistant Professor, Physiology Department, ELMC&H,LKO
Professor Seema Singh
Head, Physiology Department, Era’s Lucknow Medical College and Hospital.
Dr. Devendra Kumar
Professor, Medicine Department, Era’s Lucknow Medical College and Hospital.