The effects of chronic kidney disease stages on dyslipidemia, cardiovascular disease prevalence and mortality

Objective: Cardiovascular disease (CVD) is the most common cause of death in chronic kidney disease (CKD) patients. The prevalence of CVD is significantly increased in CKD patients, and the frequency of CVD increases as the CKD stage worsens. Although atherosclerosis is more common in CKD patients, the lipid profile may change as the CKD stage changes. Many mechanisms cause this. Also, mortality is more common in patients with advanced CKD. In this study, we aim to emphasize the incidence of cardiovascular diseases and dyslipidemia in patients with CKD at different stages and the effect of these variable conditions on patient mortality.
Methods: Patients who applied to the internal medicine outpatient clinic and were diagnosed with chronic kidney disease were examined. Mortality and complications were followed up for one year. A total of 1323 patients with a diagnosis of CKD between stages 3a-5 were included in the study. The relationships between kidney functions and lipid profiles, biochemical values, and prognosis of the patients were evaluated.
Results: Non-survivors had lower glomerular filtration rate (GFR) and higher c-reactive protein (CRP) levels. High-density lipoprotein (HDL), low-density lipoprotein (LDL), and albumin values decreased, and CRP increased as the disease stage progressed. More survivors had CKD and hyperlipidemia than non-survivors. It was observed that the stage remained the same in patients with hyperlipidemia at a higher rate. In contrast, the stage worsened or remained at stage 5 more in patients with cardiovascular disease or diabetes mellitus. Declining CKD stage and increasing CRP were influential risk factors that affect mortality.
Conclusion: It is essential to closely monitor the changes in laboratory parameters at baseline and follow-up in CKD patients to predict or prevent comorbidities, mortality, and deterioration in patients' renal functions.

Kronik böbrek yetmezliði evrelerinin dislipidemi, kardiyovasküler hastalýk prevalansý ve mortalite üzerine etkileri

Amaç: Kardiyovasküler hastalýklar (KVH), kronik böbrek yetmezliði (KBY) hastalarýnda en yaygýn ölüm nedenidir. KBY hastalarýnda KVH prevalansý normal popülasyona göre anlamlý olarak artar ve KBY evresi kötüleþtikçe de KVH görülme sýklýðý artar. Ateroskleroz, KBY hastalarýnda yaygýn olmasýna raðmen, KBY evresi deðiþtikçe lipid profili deðiþebilir. Buna neden olan birçok farklý mekanizma vardýr. Ayrýca mortalite de ileri evre KBY hastalarýnda daha sýk görülmektedir. Bu çalýþmada, farklý evrelerdeki KBY tanýlý hastalarda kardiyovasküler hastalýk ve dislipidemi insidansýný ve bu deðiþken durumlarýn hasta mortalitesi üzerindeki etkisini vurgulamayý amaçlýyoruz.
Yöntemler: Hastanemiz 2019 yýlýnda dahiliye polikliniðine baþvuran ve kronik böbrek yetmezliði tanýsý alan hastalar incelendi. Mortalite ve komplikasyonlar bir yýl süreyle takip edildi. Çalýþmaya evre 3a-5 arasýnda KBY tanýsý alan toplam 1323 hasta dahil edildi. Hastalarýn böbrek fonksiyonlarý ile lipid profilleri, biyokimyasal deðerleri ve prognozlarý arasýndaki iliþkiler deðerlendirildi.
Bulgular: Hayatýný kaybedenlerde daha düþük glomerül filtrasyon hýzý (GFR) ve daha yüksek c-reaktif protein (CRP) seviyeleri vardý. Hastalýk evresi ilerledikçe yüksek yoðunluklu lipoprotein (HDL), düþük yoðunluklu lipoprotein (LDL) ve albümin deðerleri düþerken, CRP yükselmekteydi. Hayatta kalanlarda haytýný kaybedenlere göre daha fazla KBY ve hiperlipidemi mevcuttu. Hiperlipidemili hastalarýn KBY evresinin daha yüksek oranda ayný kaldýðý görüldü. Buna karþýlýk, kardiyovasküler hastalýðý veya diabetes mellitusu olan hastalarda evre kötüleþmekte veya evre 5'te kalmaktaydý. Azalan KBY evresi ve artan CRP, mortaliteyi etkileyen etkili risk faktörleriydi.
Sonuç: KBY hastalarýnda baþlangýçta ve takipte laboratuvar parametrelerindeki deðiþikliklerin yakýndan izlenmesi, hastalarýn komorbiditeler, mortalite ve böbrek fonksiyonlarýndaki bozulmayý öngörmek veya önlemek için önemlidir. (NCI-2023-8-15)