Mantari M, Tiula E, Alikoski T, Manninen V
Effects of hypertension and dyslipidemia on the decline in
renal function
Hypertension
(Oct) 26:670-675 1995
This paper studies the effects of elevated total (non-HDL)
cholesterol levels on the progression of chronic renal
insufficiency in 2702 patients (those with complete serial
creatinine collections) forming a subgroup of the Helsinki Heart
Study. All patients in the trial were hyperlipidemic and were
randomly allocated to treatment with either gemfibrozil or
placebo. 302 were taking anti-hypertensive medications and 66
had type II DM. Over a 4-5 year follow-up there was a 5%
increase in serum creatinine in both placebo and gemfibrozil
groups. Because follow-up was relatively short, and because
patients initially had normal renal function, the overall decline
in renal function was small. However, diastolic BP > 95 mm Hg
was associated with a higher increase in SCr. An LDL/HDL ratio
of > 4.4 was not associated with an accelerated increase in SCr
in normotensive subjects, but did increase the SCr rise in
hypertensive subjects.
Comment: The study is difficult to interpret, as
only SCr was measured, and the overall change in SCr was small.
Nevertheless, the data do suggest a potential interaction of
hyperlipidemia with hypertension in accelerating the "age-
related" decline in renal function.
(Daugirdas)
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H: Special problems :
Patients with lipid disorders
CRF by problem area :
Lipids