ROLE OF DYSLIPIDEMIA IN THE PROGRESSION OF CHRONIC RENAL-DISEASE

The connection between lipids and the rate of progression of chronic r enal disease was retrospectively examined in 70 patients who were divi ded into 2 groups according to their baseline creatinine clearance (C- Cr): Group 1 (Gp1) contained 30 patients with C-Cr 60-40 mL/min follow ed for 40.0 +/- 13.3 months; Group 2 (G2) contained 40 patients with C (Cr)39-15 mL/min followed for 39.0 +/- 18.2 months. The following para meters were considered basal and final C-Cr proteinuria per unit of C- Cr (UProf/C-Cr); the difference between final and basal UProf/C-Cr (De lta UProt/C-Cr); the change in C-Cr/month (Delta C-Cr; baseline trigly cerides (TG), total (TC), HDL (HDLC) and LDL (LDLC) cholesterol, Apo A l, Apo B, Lp(a). Besides in basal C-Cr the 2 groups significantly diff ered in the final C-Cr, final UProt/C-Cr dUProt/C-Cr Delta C-Cr. No di fferences were observed concerning lipid parameters except for Lp(a) ( G1 14.8 +/- 13.6, G2 28.7 +/- 27.4 mg/dL; p < 0.05). Baseline TG (G1 1 84.1 +/- 61.3, G2 187.5 +/- 72.1 mg/dL) and Apo B (only G2 1.05 +/- 0. 32 g/L) were significantly higher than normal subjects and the Apo Al/ Apo B ratio (G1 1.42 +/- 0.43 G2 1.33 +/- 0.45) were significantly low er than in normal subjects. Delta C-Cr, while inversely correlated in both groups with Delta UProt/C-Cr (p < 0.01), only in G2 did it correl at directly with the Apo Al/Apo B ratio (p < 0.05) and inversely with Apo B and LDLC (p < 0.05). Although a correlation between Lp(a) and De lta C-Cr, was not found, 20/22 patients (3/5 G1, 17/17 G2) with a leve l > 30 mg% ran a progressive course. A natural progression of CRI, her alded by an increasing UProt, is highly frequent when baseline C-Cr is < 40 mL/min; only then lipids seem to add a burden to the renal damag e.