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The Impact of Chronic Kidney Disease on Lipid Management and Goal Attainment in Patients with Atherosclerosis Diseases in Taiwan
Authors:Tsung-Hsien Lin  Shao-Yuan Chuang  Chun-Yuan Chu  Wen-Hsien Lee  Po-Chao Hsu  Ho-Ming Su  Yi-Heng Li  Ching-Chang Fang  Kuo-Yang Wang  Wei-Kung Tseng  Ai-Hsien Li  Kwo-Chang Ueng  I-Chang Hsieh  Lien-Chi Huang  Chiun-Hsiung Wang  Wen-Harn Pan  Hung-I Yeh  Chau-Chung Wu  Wei-Hsian Yin  Jaw-Wen Chen
Abstract: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.
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