血脂代谢异常可发生在慢性肾脏病(CKD)的各个阶段。CKD患者氧化应激增加、炎症状态、肾素−血管紧张素−醛固酮系统和交感神经系统激活、同型半胱氨酸和纤维蛋白原水平升高影响血脂代谢。CKD和透析患者常见血脂异常是高甘油三酯血症,总胆固醇浓度可正常或偏低。他汀类药物用于慢性肾脏病3a-4期患者的降脂治疗,可减少心血管并发症,但在血液透析患者存在争议,腹膜透析和肾移植患者应用证据偏少。%Abnormalities of lipid metabolism may occur in the chronic kidney disease (CKD) patients at every stage. The abnormalities are caused by various factors, such as oxidative stress, inflammation, activation of renin-angiotensin- aldosterone system and sympathetic nervous system, and elevated homocysteine and fibrinogen. The most common dyslipidemia is hypertriglyceridemia in the CKD and dialysis patients, whereas their total cholesterol may be normal or lower. Statins are used for lipid-lowering therapy in stages 3a-4 CKD patients, and can reduce cardiovascular complications. However, their application is controversial for hemodialysis patients, and there was less evidence for their application in the patients with peritoneal dialysis or renal transplantation.
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