Epidemiology of dyslipidemia in chronic kidney disease.

Dyslipidemia is an established risk factor for atherosclerotic disease, such as stroke and ischemic heart disease, and is often detected in patients with chronic kidney disease (CKD). The role of dyslipidemia in CKD progression, however, is not well understood. CKD patients are heterogeneous and may include those who are malnourished or have hypoalbuminemia associated with proteinuria and a low estimated glomerular filtration rate (eGFR). Recent intervention trials showed no clear-cut benefits of statin treatment, particularly for CKD patients on dialysis. In CKD patients, multiple confounding variables such as proteinuria and the presence of cardiovascular disease may mask the effects of statins. Among them, proteinuria is a potent predictor of CKD progression (eGFR decline) and the development of end-stage renal disease. CKD patients are at high risk not only for end-stage renal disease, but also for cardiovascular disease, infection, malnutrition, and other comorbid conditions frequently associated with the elderly population. Evaluation and the target range of treatment of dyslipidemia should be individualized.