Pattern Of Lipid Profile In Dialysis Naive Chronic Kidney Disease Patients From Ilorin, Nigeria

摘要

Background: The burden of CKD is increasing rapidly worldwide and has become a major health issue. Majority of these patients die from CVD before progression to ESRD. Studies have shown that more than 50% of deaths in CKD patients are attributable to cardiovascular events. Lipid disorders are recognized risk factors for CVD and progression of renal diseases of varied aetiologies. There is paucity of information on the prevalence and pattern of lipids in CKD patients in our environment. It is for these reasons that this study was designed to determine serum lipid profile in dialysis naive CKD patients in UITH Ilorin, Nigeria. Method: It was a descriptive cross sectional study that involved 120 CKD patients and sixty age and sex matched controls. The patients were recruited consecutively from nephrology clinics and adult medical wards, while controls were sourced from hospital staff and patient’s relatives.A venous blood sample was obtained from each patient and control after an overnight fast for lipid profile and creatinine determination. The lipid fractions were analysed using standard methods. Data was analyzed with SPSS version 16. P- value <0.05 was considered significant.Results: The mean+ SEM of total cholesterol (10.5+3.6 mmol/l) and triglyceride (3.4+1.5 mmol/l) in the patients were significantly higher when compared with that of the controls (5.4+0.5 mmol/l and 1.7+0.2mmol/l) respectively, p<0.05.The leading cause of CKD was chronic glomerulonephritis. Similarly, there were significant differences in HDL, LDL and LDL/HDL ratio between the study group and controls (0.6+0.4, 0.9+0.5, and 2.1+2.6 versus 1.2+0.3, 1.4+0.4 and 1.2+0.1 mmol/l) respectively, p<0.05. However, both study group and control had total cholesterol as the most common dyslipidaemia.Conclusion: The study shows that dyslipidaemia is common among our dialysis na?ve CKD patients, most especially in those with chronic glomerulonephritis. Our findings underscore the need for early assessment of these patients for lipid abnormalities as prompt treatment may prevent cardiovascular events and retard the progression of kidney disease. Introduction The prevalence of chronic kidney disease (CKD) is increasing rapidly worldwide, and has become a major health issue1. The sensitization and awareness programme of annual World Kidney Day which began in March 2006 has sent a clear message to health care givers and general public on the burden of CKD2. In the United States, 9.6% of non-institutionalized adults are estimated to have CKD3,4. Studies from Europe, Australia, and Asia alluded to the high prevalence of CKD5-8. In Nigeria, the actual prevalence rate of this disease is not known, but hospital based studies show that it accounts for 2-8% of all admissions9,10.Majority of patients with CKD are more likely to die from cardiovascular disease (CVD) rather than develop end stage kidney failure11. Several studies have revealed that more than 50% of all deaths in CKD patients are attributable to cardiovascular diseases12,13,14. This underscores the need to look for risk factors associated with it. Lipid disorders are common among CKD patients and are recognized risk factors for CVD in CKD15,16. Lipid abnormalities also play pivotal role in the initiation and progression of glomerular and tubulo-interstitial diseases16-19. In Nigeria, studies have shown that dyslipidaemia is common among diabetic and non-diabetic population20-22.There is paucity of data on the prevalence and pattern of lipids in CKD patients in our environment. It is for these reasons that this study was designed to determine the pattern of serum lipid profile in dialysis naive CKD patients in University of Ilorin Teaching Hospital, Ilorin, Nigeria. Material and Methods It was a descriptive cross sectional study involving CKD patients, with age and sex matched controls. The control subjects were recruited from healthy hospital staff and patient relatives. Informed consent was obtained from both patient