Malnutrition, inflammation, and lipids in a cohort of dialysis patients

Rodney G Bowden, Ronald L Wilson
Postgraduate Medicine 2010, 122 (3): 196-202

BACKGROUND: This study aimed to determine if there is an association between lipid levels, serum albumin, and C-reactive protein (CRP) levels in patients on dialysis.

METHODS: Lipid profiles, albumin, and CRP levels were collected after a 12-hour fast from patients with end-stage renal disease (N = 105) who were on chronic hemodialysis. Patients were placed in an albumin group (>or= 3.8 g/dL) or a hypoalbumin group (< 3.8 g/dL), a high-risk CRP group (> 3 mg/dL) or a low-risk CRP group (<or= 3 mg/dL), and a low-risk group (low CRP and normal albumin) and high-risk group (high CRP and hypoalbumin). Lipid values included low-density lipoprotein (LDL), LDL particle number, LDL particle size, very-low-density lipoprotein (VLDL), large VLDL, high-density lipoprotein (HDL), large HDL, total cholesterol, lipoprotein A (Lp[a]), and triglycerides. All variables were measured using nuclear magnetic resonance spectroscopy.

RESULTS: Analysis of variance revealed significant differences in the hypoalbumin group, with LDL particle number being lower in this group. Analysis of variance revealed significant differences in LDL, VLDL, and LDL particle number, with lower levels in the high-risk CRP group. Analysis of variance also revealed significant differences in total cholesterol, VLDL, large VLDL, triglycerides, Lp(a), LDL, and LDL particle number when risk was combined with hypoalbumin and high CRP.

CONCLUSIONS: Our study found a counterintuitive effect in LDL and VLDL in patients with high CRP levels, in LDL particle number in patients with low albumin levels, and most variables when patients had both high CRP levels and low levels of albumin.

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