Int J Med Sci 2014; 11(4):381-388. doi:10.7150/ijms.7069 This issue Cite
Research Paper
1. Division of Cardiology, Department of Internal Medicine; Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;
2. Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
3. National Health Research Institute, Chunan, and Academia Sinica, Taipei, Taiwan;
4. Division of Cardiology, National Cheng Kung University Hospital, Tainan, Taiwan;
5. Division of Cardiology, Tainan Municipal Hospital, Tainan, Taiwan;
6. Division of Cardiology, Taichung Veterans General Hospital, Taichung, Taiwan;
7. Division of Cardiology, E-DA Hospital, Kaohsiung, Taiwan;
8. Division of Cardiology, Far Eastern Memorial Hospital, Taipei, Taiwan;
9. Faculty of Medicine, Chung Shan Medical University, Taichung, Taiwan;
10. Division of Cardiology, Linkou Chang Gung Memorial Hospital, Taipei, Taiwan;
11. Division of Cardiology, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan;
12. Division of Cardiology, Taipei City Hospital Renai Branch, Taipei, Taiwan;
13. Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan;
14. Department of Primary Care Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan;
15. Division of Cardiology, Heart Centre, Cheng-Hsin General Hospital, and Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan;
16. Division of Cardiology, Taipei Veterans General Hospital, and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
Background: Patients with chronic kidney disease (CKD) is a very high risk cardiovascular disease population and should be treated aggressively. We investigated lipid management in CKD patients with atherosclerosis in Taiwan.
Methods: 3057 patients were enrolled in a multi-center study (T-SPARCLE). Lipid goal are defined as total cholesterol (TC) < 160mg/dl, low-density lipoprotein (LDL) <100 mg/dl, high-density lipoprotein (HDL) > 40 mg/dl in men, HDL > 50 mg/dl in women, non-HDL cholesterol < 130mg/dl, and triglyceride < 150 mg/dl.
Results: Compared with those without CKD (n=2239), patients with CKD (n=818) had more co-morbidities (hypertension, glucose intolerance, stroke and heart failure) and lower HDL but higher triglyceride levels. Overall 2168 (70.5%) patients received lipid-lowering agents. There was similar equivalent statin potency between CKD and non-CKD groups. The goal attainment is lower in HDL and TG in the CKD group as compared with non-CKD subjects (47.1 vs. 51.9% and 63.2 vs. 68.9% respectively, both p < 0.02). Analysis of sex and CKD interaction on goals attainment showed female CKD subjects had lower non-HDL and TG goals attainment compared with non-CKD males (both p < 0.019).
Conclusion: Although presenting with more comorbidities, the CKD population had suboptimal lipid goal attainment rate as compared with the non-CKD population. Further efforts may be required for better lipid control especially on the female CKD subjects.
Keywords: lipid, chronic kidney disease, goal, atherosclerosis.