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Cholesterol Reduction May Help Dialysis Patients

Posted: Monday, February 09, 2004

This, the authors say, undermines the idea that high cholesterol can be protective in dialysis patients, an idea that has led some physicians to avoid treating high cholesterol in dialysis patients. In fact, investigator Dr. Josef Coresh stated that, "our study demonstrates that we need to treat hypercholesterolemia in dialysis patients."

Dr. Coresh of Johns Hopkins University, Baltimore and colleagues studied 823 patients who had recently started dialysis. Overall, 77% had evidence of inflammation or malnutrition, based on levels of serum albumin, C-reactive protein and interleukin 6.

During a median follow-up of 2.4 years, 324 patients died. Of these deaths, 159 were due to cardiovascular disease. Patients with inflammation or malnutrition had lower cholesterol levels than those without and there was a clear inverse correlation between cholesterol level and all-cause mortality.

However, among patients without inflammation or malnutrition, there was a strong, graded, positive association between serum cholesterol level and overall and cardiovascular disease mortality. "We were able to show," Dr. Coresh continued, "that when dialysis patients don't have inflammation or malnutrition, higher cholesterol predicted a progressively higher risk death."

Thus the investigators conclude that hypercholesterolemia is a risk factor for death in dialysis patients and that this association is "masked among individuals with inflammation and/or malnutrition."

Hypercholesterolemia is undertreated in kidney dialysis patients, Dr. Coresh added and. "we should implement current treatment recommendations." Furthermore, "ongoing clinical trials are looking at whether we should treat even more aggressively."

Source: Diabetes in Control.com