Lipid abnormalities in uremia, dialysis, and transplantation.
Lipid abnormalities in uremia, dialysis, and transplantation.
复制标题
尿毒症、透析和移植中的脂质异常。
作者：
M. Chan;Z. Varghese;J. Moorhead
The institution of renal replacement therapy has sustained the lives of many patients with end-stage renal failure and has made it possible to study in depth the metabolic abnormalities associated with the uremic state. An important consequence of chronic uremia is the development of lipid abnormalities [1, 2], which continue to affect many patients on dialysis [1, 3, 4] and after renal transplantation [5–7]. There has been tremendous interest in lipid metabolism in chronic renal failure, especially after the provoking report of Lindner et al that dialysis accelerates atherosclerosis [8]. Cardiovascular deaths still claim many lives on dialysis [7] and after transplantation [9, 10]. 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, dialysis, and renal transplant patients. Two basic processes regulate plasma triglyceride concentrations: triglyceride production and triglyceride removal. The factors potentially capable of affecting each process are enumerated in Table 1, and in the discussion that follows we shall try to evaluate their relative contributions to hyperlipidaemia in uremic patients.
