Study of the Relation between Dyslipidemia and Parathyroid Hormone in HCV Positive Prevalent Hemodiaylsis Patients

Abstract

Dyslipidemia in renal failure patients may be due to increased synthesis, decreased catabolism or a combination of both processes. Suggested underlying mechanisms of the reduced lipolytic activity include depletion of lipoprotein lipase (LPL) stores by repeated administration of heparin. Approximately 50% of hemodialysis (HD) patients die from cardiovascular events. One of the main risk factors for cardiovascular events is hyperlipidemia. Secondary hyperparathyroidism (SHPT) is a common abnormality inpatients with chronic kidney disease (CKD) and is associated with avariety of complications, including bone disease, uremic pruritus, refractory anemia, cognitive and sexual dysfunction, and highercardiovascular morbidity and mortality. A major complication ofSHPT is renal osteodystrophy, where as alterations in calcium andphosphorus metabolism additionally contributes to soft tissuecalcification (including cardiovascular calcification. Hyperphosphatemia, hypocalcaemia, and a progressive decline incalcitriol levels all stimulate parathyroid hormone (PTH) secretion and have long been known to contribute to the pathogenesis of SHPT. Hepatitis C virus (HCV) infection remains frequent in patient receiving long-term dialysis both in developed and less-developed countries. The natural history of HCV infection in dialysis patients remains incompletely understood. Defining the natural history of HCV remains difficult for several reasons: the disease has a very long duration, it is mostly asymptomatic, and determining its onset may be difficult. Because treatment is widely used, future natural history studies of chronic HCV may not be possible as easily documented onset of infection, that is, posttransfusion HCV, no longer occurs Hepatitis C infection associates with lipid and lipoprotein metabolism disorders such as hepatic steatosis, hypo-betalipoproteinemia, and hypocholesterolemia. Our study was conducted upon 100 patients to assess the relation between Dyslipidemia and parathyroid hormone in HCV positive prevalent hemodialysis patients; they were divided into 2 groups as regard HCV positive and HCV negative patients. We found that hypertension is the most common cause of CKD after exclusion of diabetic patients and the most common comorbidity also. We found in our study chronic hepatitis C patients had low levels of LDL, cholesterol than non-infected persons and no difference in level of PTH and serum Ca and PO4 between two groups. Finally our study shows that no relation between dyslipidemia and PTH serum level in both HCV positive patients and HCV negative patients.