Hyperlipidemias: Kasiske BL

Kasiske BL, Anonymous00342. · No affiliation provided · Am J Transplant. · Pubmed #15888073 No free full text.

This publication has no abstract.

Farbakhsh K, Kasiske BL. · University of Minnesota, Minneapolis, MN 55415, USA. · Med Clin North Am. · Pubmed #15755473 No free full text.

Abstract: Patients with CKD are at high risk for developing CVD. In fact, most CKD patients have a 10-year risk of coronary heart disease events greater than or equal to 20%, placing them in the highest risk category according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. For this reason, the National Kidney Foundation K/DOQI guidelines for managing dyslipidemia suggest that CKD patients with LDL greater than or equal to 100 mg/dL (2.59 mmol/L) should be treated with diet and a statin. The K/DOQI guidelines also make it clear that the evidence supporting treatment in CKD populations is lacking however, and that additional placebo-controlled trials are needed. In the mean time, the high incidence of CVD makes intensive monitoring and treatment of dyslipidemias in patients with CKD a reasonable clinical approach.

Sahadevan M, Kasiske BL. · Department of Medicine, Division of Nephrology, Hennepin County Medical Center, Minneapolis, Minnesota 55414, USA. · Curr Opin Nephrol Hypertens. · Pubmed #11981263 No free full text.

Abstract: Dyslipidemias are common in patients with chronic kidney disease. The causes vary with the stage of kidney disease, the degree of proteinuria, and the modality of end-stage renal disease treatment. Dyslipidemias have been associated with kidney disease progression, and a number of small, randomized, controlled trials of lipid-lowering agents have been conducted. Unfortunately, the results of these trials, although encouraging, have been inconclusive because of the small numbers of patients enrolled. Dyslipidemias may also contribute to the high incidence of cardiovascular disease in patients with chronic kidney disease. This is most likely for patients with chronic renal insufficiency and for kidney transplant recipients. Less certain is the role of dyslipidemias in the pathogenesis of cardiovascular disease among dialysis patients.

Andany MA, Kasiske BL. · Department of Medicine Hennepin County Medical Center, Minneapolis, MN 55415, USA. · J Nephrol. · Pubmed #11798152 No free full text.

Abstract: Dyslipidemias are common after renal transplantation. Most common are elevations in total and low-density lipoprotein cholesterol. Causes of dyslipidemia are usually multiple, but include immunosuppression (especially prednisone, cyclosporine and sirolimus), graft dysfunction (reduced glomerular filtration rate and proteinuria), and genetic predisposition. There is a growing amount of evidence suggesting that dyslipidemias contribute to the very high incidence of cardiovascular disease after transplantation. Less well established is whether the associations between dyslipidemias and graft dysfunction are due to a causal role of lipid abnormalities on renal injury. In any case, hypercholesterolemia, and especially increases in low density lipoprotein cholesterol, should be treated using guidelines established for patients in the general population.

Kasiske BL. · University of Minnesota College of Medicine, Department of Medicine, Hennepin County Medical Center, Minneapolis 55415, USA. · Semin Nephrol. · Pubmed #10746859 No free full text.

Abstract: Cardiovascular disease (CVD) is common after renal transplantation. In the absence of controlled intervention trials, the strength of evidence that modifying a risk factor will reduce the incidence of CVD in renal transplant recipients must rest on: (1) evidence from studies in the general population, (2) observational studies linking the risk factor to CVD in renal transplant recipients, and (3) studies showing that the risk factor can be safely and effectively treated in transplant patients. Accordingly, the evidence is strong that hyperlipidemia should be treated after renal transplantation. Evidence is very suggestive that pretransplant screening for CVD, treatment of hypertension, the use of low-dose aspirin, and smoking cessation will also help to reduce the incidence of posttransplant CVD. Less compelling are data suggesting that intensive glucose control in diabetics will safely decrease the incidence of CVD. Although there is little evidence that treatment of erythrocytosis will reduce CVD, hematocrits above 55% to 60% should probably be treated to prevent venous thrombosis. Vitamins for reducing homocysteine, antioxidant vitamins, and prophylaxis for potentially atherogenic infections are therapies that warrant additional study. In summary, the best current approach to reducing the high incidence of posttransplant CVD is to aggressively identify, and then systematically treat modifiable risk factors.

Kasiske BL. · Hennepin County Medical Center, Minneapolis, Minnesota, USA. · Kidney Int. · Pubmed #11786124 links to  free full text

This publication has no abstract.