LIPID ABNORMALITIES IN UREMIA
Lutfi Zulbeari, Kastriot Haxhirexha, Nasir Behxheti, Sadi Bexheti, Sihana Ahmeti Lika, Jetmire Alimani Jakupi
Abstract
Lipid metabolism disorders in patients with end stage renal disease, particularly in patients with nephrotic syndrome were described by Dr Bright in the 1827 year (1).There has been tremendous interest in lipid metabolism in chronic renal failure, that dialysis accelerates atherosclerosis. Cardiovascular disease, still claim many lives on dialysis (2, 3) and after transplantation (4, 5, 6). We realize hyperlipidemia is only one, and may not be the most important one, of the risk factors in the development of ischemic heart disease in patients with uremia and shall restrict ourselves to the review of the current understanding of the pathogenesis of hyperlipidemia in uremic patients with dialysis. Two basic processes regulate plasma triglyceride concentrations: triglyceride production, triglyceride removal.It is known that patients with end-stage renal disease (ESRD) display clinical picture of early accelerated (premature) atherosclerosis with severe cardiovascular and cerebral complications that are very often present even in earlier age compared with the general population.Today, it is considered that uremic dyslipidemia has persisted for many years before chronic dialysis treatment began and presents basic risk factor for early start of atherogenesis processes. That is why the analysis of apolipoprotein and lipid abnormalities as well as their ethiopathogenetic mechanism in patient diseased with ESRD treated with repeated hemodialysis in the initiation phase of dialysis (the first 6 months), can evidently contribute to overtaking timely preventive measures (dietetic, healing) by which the frequency of apolipoprotein and lipid abnormalities will be decreased, which, on the other hand will result in reducing the processes of early atherosclerosis with all its complications in ESRD patients. Disorders of apolipoprotein metabolism are considered as one of the most important factors for early atherosclerosis in patients with ESRD.
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6 - 13