The Relationship Between Lipid Metabolism And Renal Function Progression In Patients With Chronic Kidney Disease

Objective:We aim to study the correlation between the serum lipid metabolism and nephropathy progression. Our study provided data from the research perspective, which then contributes to the reasonable clinical regulation of serum lipid metabolism in chronic kidney disease (CKD) patients.Methods:Our samples were collected from 446 patients that agreed to participate in this research in Chinese PLA General Hospital Nephrology hospitalization from July 2014 to April 2015. We recorded the general clinical data includes personal background and medical history, whether the patient had essential hyperlipidemia or family history of hyperlipidemia, the general body indexes (height, weight, blood pressure), blood test, comprehensive metabolic panel,include trioxypurine,creatine, carbamide,the lipid indexes:total cholesterol (TC),triglyceride (TG),high density lipoprotein (HDL),low density lipoprotein (LDL),and Parathyroid hormone (PTH), Cystatin C, homocysteine, urinalysis, quantitative test for urinary protein and microalbuminuria et. al. A part of patients have renal biopsy pathology. Then builted an EXCEL database. We then calculated the body mass index (BMI), the estimated glomerular filtration rate (eGFR) with EPI formula, and classified the patients by CKD according to the K/DOQI manual, through which it improved our clinical database.We analyzed the correlation between the serum lipid metabolism markers and the kidney disease clinical indexes in CKD patients.We first selected 221 patients who accord with our standard of inclusion and exclusion.Calculated eGFR and classified the patients into A group (eGFR≥60 ml/min·1.73m2), B group (eGFR=30-60ml/min·1.73m2), and C group (eGFR<30ml/min·1.73m2). Then, comparing the differences of serum lipid indexes among three groups, and studied the correlation between serum lipid indexes and kidney indexes. We applied multi-variable regression analysis and studied the factors that influence serum lipid abnormality and kidney disease progression in CKD patients.In the second part, we studied the correlation between those two in IgA nephropathy (IgAN) patients. Selected 110 IgAN patients who accord with our standard of inclusion and exclusion; calculate eGFR. The patients were grouped into three groups according to the same criteria mentioned above. Then similarly, compared the difference between serum lipid index and IgAN clinical indexes in each group, and applied multi-variant regression analysis to study the factors affecting serum lipid metabolism and kidney disease progression in IgA patients.Results:In the first part, with the descend of eGFR the consistence of TC is higher,and hypercholestermia,hypertriglyceridemia,elevate of LDL and descend of HDL have obviously relationship with the increase of creatinine. Hypercholestermia and elevate of LDL are related to albuminuria.The second part show that elevation of TC is obvious when eGFR<60ml/min·1.73m2.The level of TC is related to creatinine and albuminuria,the elevate of TG have relationship with creatinine and he elevate of TG with albuminuria.Conclusion:Our study mainly studied the correlation between serum lipid clinical spectrum and kidney disease indexes in CKD patients.The results show that the serum lipid metabolism is related to This might affect the prognosis of IgAN. The high TC and high LDL are both correlated to the progression of CKD and need ue pay attaion to it.