Lipid Profile in Children with Chronic Renal Failure on Conservative Therapy and with regular Hemodialysis

Background: Abnormalities in lipid metabolism can be detected in children with chronic kidney diseases (CKD) and may constitute a major atherogenic risk factor.
Objectives: To evaluate the prevalence and types of uremic dyslipidemias in children at different stages of renal impaired and modes of treatment.
Methods: We studied total cholesterol, triglycerides (Tg), low density lipoprotein (LDL), and high density lipoprotein (HDL) in 28 children with CKD on conservative therapy (21 males, 7 females with median age 6.5 years), and another 22 children under regular hemodialysis for at least 6 months (13 males, 9 females with median age 12 years). Ten healthy sex-matched children with age ≥ 10 years (median age 12 years) were taken as control.
Results: The characteristics abnormalities in lipid profiles in the conservative group were elevated (˃95^th percentile of normal reference values) Tg in 53.5%, and total cholesterol in 21.4%. However, in the hemodialysis group hypertriglyceridemia and lowered (˂5^th percentile of normal reference values) HDL were detected in 77% and 90.9% respectively. On comparing lipid profiles in a subgroup of conservative children ≥ 10 years old (10 children, 7 males and 3 females with median age 12 years) and control, there was a significant increase in median concentrations of Tg (101 vs. 67.5 mg/dl, p = 0.021), and a significant decrease of median HDL concentrations (41.1 vs. 53.5 mg/dl, p = 0.002), as well as insignificant differences in median total cholesterol (173.4 vs. 160 mg/dl, p = 0.125) and LDL concentrations (101.9 vs. 97 mg/dl, p = 0.211) in patients. When the Hemodialysis was compared to the control group, there were a significant increase in Tg concentrations (median 134.5 mg/dl, p = 0.001) and a significant decrease in median concentrations of cholesterol (119 mg/dl, p = 0.002), LDL (63.5 mg/dl, p = 0.001), and HDL (23 mg/dl, P = 0.0001) in patients.
Conclusions: Abnormalities in basic lipid profiles were more frequently detected in children with CKD under regular hemodialysis than those on conservative therapy only. It is recommended to evaluate dyslipidemias in these children more than in the general population, and early intervention might be of a protective value for the cardiovascular system.