Statin therapy is associated with decreased small, dense low-density lipoprotein levels in patients undergoing peritoneal dialysis

Abstract

Cardiovascular disease is a major cause of morbidity and mortality among hemodialysis (HD) and peritoneal dialysis (PD) patients, and dyslipidemia plays an important role in its pathogenesis. In particular, small, dense LDL (sd-LDL) particles have been recently highlighted as an emerging cardiovascular risk factor. PD patients exhibit a more overtly abnormal lipid profile than HD patients, probably due to the metabolic interference of the peritoneal dialysis fluid. Statins are the main drugs for the treatment of dyslipidemia and they are able to decrease all LDL subclasses levels, but it remains unclear whether they can influence the proportion of sd-LDL. Only few studies regarding the effect of statins on the proportion of these particles have been performed in HD patients and, to our knowledge, no trials have been carried out in PD patients. Therefore, we compared the lipid profile and the proportion of sd-LDL in two populations of HD and PD patients. Our study suggests that statin therapy may be effective in reducing both the absolute amount and the proportion of sd-LDL in patients with a more overtly abnormal lipid profile, such as patients undergoing peritoneal dialysis. Statins do not seem to be effective in altering sd-LDL levels in patients undergoing hemodialysis with other factors that can influence LDL subtractions generation, such as hypertension and diabetes mellitus. If and when our results prove to be reproducible in large-scale studies, such studies should provide new insights into sd-LDL and its actual role in atherogenesis in patients undergoing hemodialysis or peritoneal dialysis.