PLASMA-LIPID PROFILE AND CORONARY-ARTERY DISEASE IN BRAZILIAN HEMODIALYSIS-PATIENTS

We studied the prevalence of lipid disorders and of coronary artery di sease and the main factors affecting plasma lipids in a cohort of Braz ilian hemodialysis patients. The investigation comprised 75 adult hemo dialysis patients and 200 normal controls matched for age, sex, race a nd body mass index. Mean values for plasma lipids were within normal l imits in the dialysis group. Total cholesterol (184 +/- 44 vs. 201 +/- 46 mg/dl), LDL (110 +/- 36 vs. 131 +/- 44 mg/dl) and HDL (40 +/- 13 v s. 47 +/- 12 mg/dl) were significantly lower in the dialysis patients (P < 0.01), whereas VLDL (32 +/- 14 vs. 21 +/- 12 mg/dl) and triglycer ide (161 +/- 71 vs. 111 +/- 70 mg/dl) were increased (P < 0.01). Incre ased triglyceride was observed in 24% of the dialysis patients, a prev alence two to three times lower than that reported in the literature. In the dialysis group, the variables positively related to total chole sterol were hypertension (P < 0.05) and gender (female) (P < 0.05); to LDL and HDL, hypertension (P < 0.05 and P < 0.01, respectively); and to triglyceride, use of propranolol (P < 0.01). Age, race, duration of hemodialysis, body mass index and plasma creatinine did not affect pl asma lipids. The prevalence of coronary artery disease, established by invasive and noninvasive methods, was 10.7% while in the literature 2 0-35% of the unselected hemodialysis patients present obstructive coro nariopathy. We conclude that the plasma lipid profile of Brazilian hem odialysis patients is similar to those reported in American and Europe an literature, whereas the prevalence of hypertriglyceridemia and of c oronary artery disease appears to be reduced.