关键词: 肾透析, 心血管疾病, 血脂

Abstract: Objective To investigate the changes of lipid profile, and explored the risk factors of lipid abnormalities in maintenance hemodialysis(maintenance hemodialysis, MHD) patients. Methods A total of 205 cases on MHD were enrolled in this study. Among them, 51 patients were below 45 years of age. The following data were collected: age, gender, dialysis duration, serum albumin, lipid profile, etc. T test, χ² test and binary logistic regression analysis were performed for statistics. Results Among the 205 MHD patients, 145 MHD patients had lipid abnormalities. The prevalence of lipid abnormalities in MHD patients was 70.7%. The main characteristics were high density lipoprotein cholesterol(HDL-C) decreasing(HDL-C<1.03 mmol/L), low density lipoprotein cholesterol(LDL-C) increasing(HDL-C<1.03 mmol/L) and triglyceride(TG) increasing(TG≥1.69 mmol/L), and their prevalence were53.2％(109/205), 28.3％(58/205) and 26.8％(55/205), respectively. At the boundary of 45 years old, all the MHD patients were divided into two groups, young(n=51) and middle-and old-aged group(n=154). Among the 51 young-aged MHD patients, 36 cases had lipid abnormalities, the prevalence of lipid abnormalities in young-aged MHD patients was 70.6%, which was no significant different as compared with middle-aged and old-aged MHD patients(χ²=0.001, P=0.979). There were no significant differences in terms of age, serum albumin, lipoprotein a, and the primary diseases of chronic renal failure, such as chronic glomerulonephritis, chronic interstitial nephritis, diabetic nephropathy, hypertensive nephropathy, lupus nephritis, polycystic kidney, obstructive nephropathy and chronic pyelonephritis, between lipid abnormalities and lipid normalities patients. The level of dialysis duration, male female ratio and kidney transplant failure ratio were significantly higher in MHD patients with lipid abnormalities than in those without lipid abnormalities. Logistic regressive analysis revealed that male, dialysis duration and transplanted kidney failure were the important risk factors of lipid abnormalities in MHD patients. Conclusion The prevalence of lipid abnormalities in MHD patients was quite high. The main characteristic were HDL-C decreasing, LDL-C and TG increasing.The prevalence of lipid abnormalities in young MHD patients was similar to middle-aged and old-aged MHD patients. Male, dialysis duration and kidney transplant failure were the important risk factors of lipid abnormalities in MHD patients.

Key words: renal dialysis, cardiovascular disease, blood lipid