演題情報

学会・委員会企画

開催回
第56回・2011年・横浜
 

Dyslipidemia and Atherosclerotic Cardiovascular Disease in Hemodialysis Patients

演題番号 : GI-7-4

Tetsuo Shoji:1

1:Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan

 

【Background】 A paradoxical epidemiology is known between serum cholesterol and risk of death from all-cause and cardiovascular disease (CVD) in subjects treated with hemodialysis. Also, a lower body mass index (BMI) is a predictor of CVD death among these patients. However, it is unknown whether or not these factors also predict incident CVD. We previously proposed a hypothesis that dyslipidemia promotes atherosclerosis and incident atherosclerotic CVD events, and that malnutrition or protein-energy wasting (PEW) increases the risk of death after such events. We tested this hypothesis using data from a nationwide registry of dialysis patients in Japan.  【Methods】 Observational cohort study in 45,390 hemodialysis patients using a standard analysis file (JRDR-09108) from JSDT.  【Results】 The risk of new onset of myocardial infarction (MI) was positively associated with Non-HDL-C and inversely with HDL-C. The risk of cerebral infarction (CI) was similarly but less impressively associated with these lipid measurements. The risk of cerebral bleeding (CB) was not significantly associated with lipids. The risk of death after these CVD events was not associated with lipid parameters but with BMI (inversely) and CRP (positively).  【Conclusions】 These data clearly showed that dyslipidemia increases the risk of incident atherosclerotic CVD, and that PEW are the independent factors associated with a high risk of fatality after CVD events. (This study was conducted as one of the researches by the Committee of Renal Data Registry; JSDT-CRDR).

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