chronic renal failure and hyperlipidaemia
Last reviewed 10/2023
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