Abstract
Patients on hemodialysis are at an increased risk for atherosclerosis, and metabolic abnormalities associated with uremia may stimulate the atherosclerosis. Major lipid abnormalities in hemodialysed and CAPD patients are hypertriglyceridemia, hypercholesterolemia, lower level of HDL-cholesteroleremia and higher level of IDL. CAPD patients with hyperlipoproteinemia had significantly higher serum albumin level, and which correlated with apo B level as same as the pathophysiology of nephrotic syndrome. The mechanisms and pathophysiology of uremic hyperlipotroteinemia were evaluated here, and the effectiveness and safety of clinofibrate and pravastatin were shown in the patients on hemodialysis and CAPD as a major drug therapy for them. Since serum level of cholesterol correlated positively to the levels of apo B/A-I ratio, non-HDL cholesterol and IDL, cholesterol level was a useful monitoring parameter for the treatment. Our results suggested that the range for drug therapy in hemodialysed patients is over 200mg/dl of serum cholesterol, and the range of goal is less than 180mg/dl.
