Dietary treatment of hyperlipidemia in chronic hemodialysis patients

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Abstract
Plasma cholesterol and triglyceride levels were measured in 131 patients on hemodialysis and in 131 age and sex matched controls. Of the dialysis patients 65% had abnormalities in their plasma lipoproteins: type IV 39%, type IIB 21%, and type IIA 5%/ Triglyceride levels were higher in dialysis patients than in control subjects, (mean = 2.31 ± SEM 0.10 mmole versus 1.32 ± 0.05 mmole/liter; P = < 0.001) but there was no statistical difference in the cholesterol values between the two groups. Twenty dialysis outpatients with hyperlipoproteinemia (10 with type IV, and 10 with type IIB) were given diets for 1 month planned to reduce their intake of fat, to limit cholesterol to less than 300 mg daily, and to alter the ratio of saturated to polyunsaturated fat from 4:1 to 1:1. Carbohydrate intake was increased to achieve the same calorie value as pretreatment diets. Plasma levels of triglyceride fell significantly in patients with type IV (2.97 ± 0.18 to 2.07 ± 0.11 mmole/liter; P = < 0.001) and type IIB hyperlipoproteinemia (3.47 ± 0.36 to 2.62 ± 0.20 mmole/liter; P = < 0.01). In type IIB patients plasma levels of cholesterol also decreased (8.33 ± 0.48 to 6.82 ± 0.51 mmole/liter; P = < 0.01). Twelve patients studied after resuming their original diets, reverted towards their pretreatment lipoprotein abnormalities. If hyperlipidemia contributes to the high mortality from cardiovascular and cerebrovascular disease in dialysis patients, simple dietary modification may be an effective treatment.