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Chronic renal failure and hyperlipidaemia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Hypertriglyceridaemia is the characteristic hyperlipidaemia associated with chronic renal failure (without proteinaemia):

  • proportion of triglyceride in VLD and LDL is increased
  • decreased rate of activity of lipoprotein lipase and hepatic lipase - remnant particles persist for long in the circulation
  • haemodialysis leads to an exacerbation of hypertriglyceridaemia:
    • heparin leads to a depletion of lipoprotein lipase
    • apolipoprotein CII (co-factor for lipoprotein lipase) is removed from the circulation
  • chronic ambulatory peritoneal dialysis results in absorption of large amounts of glucose which predisposes to obesity (thus exacerbating hypertriglyceridaemia)
  • lipoprotein (a) (Lp(a)) levels are raised in renal disease
  • HDL levels are low

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