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The cholesterol paradox is flawed; cholesterol must be lowered in dialysis patients.

Abstract

In the general population, elevated cholesterol is associated with cardiovascular disease and mortality and lowering cholesterol is associated with improved outcomes. This reflects the predominance of isolated atherosclerotic coronary disease in the general population. In patients with renal disease, however, the relationship between serum lipids and cardiovascular outcomes is much less clear and even reversed. In our opinion, the relationship between cholesterol and coronary disease is obscured by high levels of co-morbid disease, malnutrition, inflammation, atypical dyslipidemia and the fact that myocardial infarction is not the typical presentation of cardiovascular disease in patients with renal disease. Thus, cholesterol lowering will still be effective in patients with chronic kidney diseases.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    BHF Cardiovascular Research Centre, University of Glasgow, and Renal Transplant Unit, Western Infirmary, Glasgow, United Kingdom.

    ,

    Source

    Seminars in dialysis 20:6 pg 504-9

    MeSH

    Cardiovascular Diseases
    Cholesterol
    Clinical Trials as Topic
    Dyslipidemias
    Humans
    Hyperlipidemias
    Inflammation
    Kidney Failure, Chronic
    Malnutrition
    Models, Cardiovascular
    Renal Dialysis
    Risk Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    17991195

    Citation

    Wan, Ray K., et al. "The Cholesterol Paradox Is Flawed; Cholesterol Must Be Lowered in Dialysis Patients." Seminars in Dialysis, vol. 20, no. 6, 2007, pp. 504-9.
    Wan RK, Mark PB, Jardine AG. The cholesterol paradox is flawed; cholesterol must be lowered in dialysis patients. Semin Dial. 2007;20(6):504-9.
    Wan, R. K., Mark, P. B., & Jardine, A. G. (2007). The cholesterol paradox is flawed; cholesterol must be lowered in dialysis patients. Seminars in Dialysis, 20(6), pp. 504-9.
    Wan RK, Mark PB, Jardine AG. The Cholesterol Paradox Is Flawed; Cholesterol Must Be Lowered in Dialysis Patients. Semin Dial. 2007;20(6):504-9. PubMed PMID: 17991195.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The cholesterol paradox is flawed; cholesterol must be lowered in dialysis patients. AU - Wan,Ray K, AU - Mark,Patrick B, AU - Jardine,Alan G, PY - 2007/11/10/pubmed PY - 2008/2/2/medline PY - 2007/11/10/entrez SP - 504 EP - 9 JF - Seminars in dialysis JO - Semin Dial VL - 20 IS - 6 N2 - In the general population, elevated cholesterol is associated with cardiovascular disease and mortality and lowering cholesterol is associated with improved outcomes. This reflects the predominance of isolated atherosclerotic coronary disease in the general population. In patients with renal disease, however, the relationship between serum lipids and cardiovascular outcomes is much less clear and even reversed. In our opinion, the relationship between cholesterol and coronary disease is obscured by high levels of co-morbid disease, malnutrition, inflammation, atypical dyslipidemia and the fact that myocardial infarction is not the typical presentation of cardiovascular disease in patients with renal disease. Thus, cholesterol lowering will still be effective in patients with chronic kidney diseases. SN - 0894-0959 UR - https://www.unboundmedicine.com/medline/citation/17991195/full_citation L2 - https://doi.org/10.1111/j.1525-139X.2007.00359.x DB - PRIME DP - Unbound Medicine ER -