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Organ and Metabolic Complications: Lipids/Atherosclerosis

  • Chapter
Replacement of Renal Function by Dialysis

Abstract

The incidence of and mortality from atherosclerotic complications, particulary coronary atherosclerosis, is strikingly increased in dialysed patients. One of the factors involved is dyslipoproteinemia. The main cause of dyslipoproteinemia is reduced activity of enzymes catabolising lipoproteins (hepatic triglyceride lipase, lipoprotein lipase), but additional abnormalities clearly contribute. Specific patterns of dyslipoproteinemia are present in patients with the nephrotic syndrome, diabetes mellitus and with immunosuppression (steroids, cyclosporin A). A paradoxical inverse relationship is noted between several lipid indicators and cardiac mortality in dialysis patients. This is presumably due to the confounding effect of malnutrition. Lipid indicators like Lp(a) and apolipoprotein ratios (AI/CIII) are predictive of atherosclerotic vascular disease, however, particularly in the high risk population of diabetics

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Authors and Affiliations

  1. Department of Internal Medicine, Ruperto Carola University, Bergheimerstr. 58, D-69115, Heidelberg, Germany

    Eberhard Ritz M.D., Ph.D.

  2. Department Nephrology, Silesian School of Medicine, Katowice, Poland

    Michal Nowicki M.D.

  3. Department of Nephrology, Silesian School of Medicine, Francuska 20, 40-027, Katowice, Poland

    Andrzej Wiecek M.D.

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  1. Eberhard Ritz M.D., Ph.D.
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  2. Michal Nowicki M.D.
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  3. Andrzej Wiecek M.D.
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C. Jacobs C. M. Kjellstrand K. M. Koch J. F. Winchester

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© 1996 Kluwer Academic Publishers

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Ritz, E., Nowicki, M., Wiecek, A. (1996). Organ and Metabolic Complications: Lipids/Atherosclerosis. In: Jacobs, C., Kjellstrand, C.M., Koch, K.M., Winchester, J.F. (eds) Replacement of Renal Function by Dialysis. Springer, Dordrecht. https://doi.org/10.1007/978-0-585-36947-1_40

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  • DOI: https://doi.org/10.1007/978-0-585-36947-1_40

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