Korean Journal of Nephrology 1992;11(4):417-426.

지속성 외래 복막 투석 환자에서 혈청 지질의 변화양상과 고콜레스테롤혈증 발생 위험인자에 대한 연구

김흥수 , 김기용 , 박찬신 , 조한선 , 최규헌 , 하성규 , 이호영 , 한대석

Abstract

It is well known that cardiovascular disease appears to be the leading cause of death in patients receiving long-term dialysis, and the hyperlipidemia is a major factor accelerating the atherosclerosis. But not all of the patients receiving the dialysis was found to be hyperlipidemic. So, to evaluate the serum lipid abnormalities and the risk factors causing the hypercholesterolemia during the continuous ambulatory peritoneal dialysis, the authors studied 102 CAPD patients who were followed more than 12 months after the CAPD on the Severance hospital until March 1991 with particular emphasis on the changes in the lipid profiles and the biochemical parameters, and divided the patients into three groups according to the delta cholesterol (difference of cholesterol between before and after 12 months of CAPD) to find the risk factors that might be related with hypercholesterolemia after the CAPD. 1) Total patients number of group 1 ( cholesterol < 0 mg/dl), group 2 ( cholesterol: 0-50 mg/dl), group 3 ( cholesterol>=50 mg/dl) were 27, 45, 30 patients in each and the male female ratio were 15:12, 23:22, 9:21 in each group where in group 3 female ratio was relatively the highest. 2) Serum cholesterol level in group 1 was continuous- ly low than the level before the start of CAPD through- out the 12 months, and the level of cholesterol was increased after 1 month of CAPD in group 2 and 3 compared to the level before the CAPD (p<0.05) and showed progressive increment throughout the 12 months. 3) Serum triglyceride level was increased after 2 months of CAPD compared to the level before the CAPD in group 2 (p<0.05), but there was no difference in group 2 and 3. 4) There was no difference in HDL-cholesterol level after the CAPD compared to the level before the CAPD throughout the 12 months in each group. 5) It showed inverse relationship between the level of cholesterol before the CAPD and the cholesterol level (Y = -0. 51 x +184. 2, correlation coefficient = -0,551). 6) Seven possible risk factors sex, age, serum total protein (the value on the 12 month), serum albumin (the value on the 12 month), serum BUN/Creatinine ratio (the value on the 12 month), peritonitis incidence (epi- sodes per year), change of patients weight according to the ideal body weight (the value on the 12 month) were analyzed by multiple regression analysis which revealed that only the sex was statistically significant (Significant - T = 0. 016). These findings suggest that the serum cholesterol level tend to increase during the CAPD but not in all patients on CAPD and the increment of the cholesterol level was apparent in female sex and who had lower levei of cholesterol before the start of CAPD. So we need a special interest and diet therapy in the CAPD patients who are female or who had low level of choles- terol before the CAPD. But further prospective studies are required to determine the risk factors with regard- ing more possible risk factors.