A recent study sponsored by the National Institute of Health of the African American Study of Kidney Disease and Hypertension found a link between high cholesterol levels and increased kidney disease treatment problems.
To better understand the impact of cholesterol levels on the treatment of kidney disease, physicians need to take into account malnutrition and inflammation status of chronic kidney disease patients.
Individuals living with chronic kidney disease often develop cardiovascular disease and die from heart complications. In the general population its well know high cholesterol levels put you at an increased risk for cardiovascular disease, the relationship between kidney disease and cholesterol levels is not as clear. Research has actually shown individuals with high cholesterol and receiving dialysis diet at lower rates than those with lower cholesterol levels. This isn't to say high cholesterol is desirable, but it may indicate a reduced degree of malnutrition and inflammation. Malnutrition and inflammation are two serious complications of kidney disease.
Dr. Gabriel Contreras and Lawrence Appel tracked 990 individual medical records for African Americans with hypertension and chronic kidney disease not yet on dialysis for a 12 year period. Thirty-one percent of the 990 patients had malnutrition and/or inflammation. Contreras and Appel were investigating to see whether malnutrition and inflammation modified the relationship between cardiovascular disease and cholesterol.
Over the 12 year study period, 20%, 20% of patients experienced a cardiac event (i.e. heart attack, stroke, congestive heart failure, or death from heart disease) and with similar percents in each group - 19% with and 21% without. By each group I'm referring to patients ‘with' and ‘without' malnutrition and inflammation. High cholesterol was not linked to cardiovascular events in patients with malnutrition and/or inflammation. For the 69% of patients without malnutrition and/or inflammation their risk of a new cardiac event increased with rises in cholesterol. When patients with different cholesterol levels were compared, those with total cholesterol levels between 200-239 mg/dl had a 1.19-fold increase in risk compared to those with total cholesterol levels less than 200 mg/dl and a 2.18-fold increase for individuals with total cholesterol levels greater than or equal to 240 mg/dl.
The study emphasizes the importance of not only monitoring cholesterol levels, but the need to take into account the role of malnutrition and inflammation for those with chronic kidney disease. High cholesterol levels appear to compete and interact with non-traditional risk factors.
If you are being treated for chronic kidney disease you want to discuss with your physician both traditional risk factors, such as your cholesterol levels, and non-traditional risk factors, such as malnutrition and inflammation, to ensure traditional tests are interpreted correctly and your treatment plan is appropriate. It's important your physician investigates the cause of high or low cholesterol test results.
Watch for this study to appear in the Journal of the American Society of Nephrology.
Published On: October 06, 2010