DISTRIBUTION & DETERMINANTS OF LIPID DISORDERS IN PATIENTS UNDERGOING HEMODIALYSIS

Abstract

Introduction: Patients with end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) exhibit a distinct lipid profile marked by hypertriglyceridemia, low HDL, and paradoxically low or normal cholesterol, influenced by malnutrition and inflammation. Hemodialysis further alters lipid and protein levels, affecting risk assessment. Given the high cardiovascular burden, this study evaluates lipid abnormalities, their determinants, and related cardiovascular findings. Aim and Objective: To evaluate the distribution and determinants of lipid abnormalities in patients undergoing maintenance hemodialysis (MHD), examine the paradoxical impact of low lipid levels, compare pre- and post-dialysis lipid profiles and serum albumin, and assess cardiovascular involvement using ECG and 2D echocardiography. Materials and Methods: A serial cross-sectional study was conducted on 150 adult patients with end-stage renal disease (ESRD) receiving regular MHD at Sree Balaji Medical College & Hospital over a period of 10 months. Biochemical parameters, including lipid profile and serum albumin, were measured before and after dialysis. Cardiovascular abnormalities were evaluated using ECG and 2D echocardiography. Results: The mean age of participants was 54.98±18.15 years, with a male predominance (67%). Hypertension (80%) and diabetes (50%) were the most common comorbidities. Hypertriglyceridemia was the most frequent lipid abnormality (79%), followed by low HDL levels (48%) and hypolipidemia (22%). Post-dialysis analysis showed significant reductions in total cholesterol (176.49 to 165.10 mg/dL, p=0.004), LDL (95.66 to 86.20 mg/dL, p=0.008), and VLDL (40.34 to 36.80 mg/dL, p<0.001). Serum albumin levels also declined significantly after dialysis (3.00 to 2.80 g/dL, p<0.001). Cardiovascular abnormalities were common, with ECG changes observed in 50% of patients, diastolic dysfunction in 33%, and cardiovascular events in 33%. Conclusion: Hemodialysis patients show a distinct dyslipidemia pattern with high triglycerides, low HDL, and paradoxically low cholesterol. Dialysis reduces atherogenic lipids, but the high cardiovascular burden necessitates targeted monitoring and individualized management.