, Volume 42, Issue 1, pp 133-136
Date: 14 Oct 2009

Jupiter or Aurora? Micro-inflammation and dyslipidaemia: twin targets for statin therapy in CKD

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Dyslipidaemia is nearly ubiquitous in chronic kidney disease—although the nature and extent of the phenotypic abnormality profile vary as CKD severity increases, and with dialysis and transplantation [1]. In the non-CKD setting, dyslipidaemia is a key factor in the development and progression of atherosclerosis. Atherosclerosis is known to be an inflammatory process, and not just a lipid-storage problem and of course in CKD it is also well known that there is chronic elevation of CRP and IL-6 in many patients [2]. Interestingly, while elevation in CRP is strongly associated with adverse outcomes in CKD [3], there is a “reverse epidemiology” relationship between plasma cholesterol and outcome in advanced CKD (such that low cholesterol levels are strongly associated with increased mortality [4]). This apparently perverse/inverse relationship, in marked contrast to the general population, continues to puzzle nephrologists (as similar observations do for body weight and blood pressure [5]) ...