اضطرابات الشحوم عند مرضى الداء الكلوي النهائي الخاضعين للتحال الدموي

الملخص EN

Introduction : The commonest cause of death in patients with end-stage renal disease (ESRD) on maintenance haemodialysis (MHD) is coronary heart disease (CHD).

It has been suggested that dyslipidemia, an important CHD risk factor, may be worsened by dialysis.

Aim : This study was aimed to evaluate the changes in blood lipoproteins after dialysis in ESRD patients on MHD , and to assess the relation between serum lipid concentrations and some demographic , clinical , and therapeutic factors .

Materials and Methods : This was a prospective study , the subjects were 153 (91 M, 62 F; 32 diabetic, 121 non-diabetic) patients with ESRD, aged 17–82 years, undergoing MHD at a dialysis unit in Al-Assad and Tishreen University Hospital /Lattakia / Syria during the period between March 2016 – March 2017 .

Pre- and post-dialysis non-fasting blood samples were collected from each subject on the same day, and analyzed for plasma glucose , Urea , creatinine , triglycerides (TG), total cholesterol (TC), HDL, and LDL.

Pre- and post-dialysis levels for each of the analytes were compared and linear correlations sought between Δ values (corresponding to differences between pre- and post-dialysis levels) of the lipoproteins.

The relation between blood lipids concentration and each of age ,sex ,smoking , alcoholism , the cause of chronic renal failure , the period of dialysis , the used heparin dose , diabetes mellitus , insulin and other drugs , and concomitant diseases was assessed .

Results : There was a general trend towards significant increases in post-dialysis TC, HDL, and LDL The pre- to post-dialysis increases were: TC 13.46 %, HDL 25.4%, LDL 15.9% .

Males had lower HDL levels than females (P<0.05) .

Patients who experienced a weight increase > 3 Kg between dialysis times had higher levels of TC , HDL , and LDL (P<0.05) .

No significant relation was found between lipids serum levels and any of the following factors : age , smoking , alcoholism , the cause of chronic renal failure , the period of dialysis , the used heparin dose , diabetes mellitus , or insulin use .

Conclusion : We speculate that, with repeated dialysis, dyslipidemia may get progressively worse and further accentuate CHD risk.