Kalaivani, R (2017) Evaluation of Serum Lipoprotein(a) levels and novel Lipid Indices in patients with Chronic Kidney Disease. Masters thesis, Stanley Medical College, Chennai.
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Abstract
BACKGROUND: Majority of Chronic kidney disease patients are more likely to die of Cardiovascular complications before reaching end stage renal disease. Although there are many risk factors contributing to pathogenesis of cardiovascular disease in CKD subjects, Dyslipidemia represents one of the modifiable risk factors. American Heart Association has recommended that CKD patients should be classified in the highest risk group for developing cardiovascular events. K/DOQI recommends these patients should be evaluated for dyslipidemia and for treatment to reduce the risk of cardiovascular events. AIM & OBJECTIVES: To evaluate Serum Lp(a), lipid profile, novel lipid indices in predialysis CKD subjects and compare with that of healthy controls. To find the correlation between Serum Lp(a) and novel lipid indices across Stages 1 to 5 of CKD. METHODOLOGY: This was a case control study that included 70 predialysis CKD subjects and 70 healthy control subjects, adhering to inclusion and exclusion criteria. Fasting blood samples were collected and analyzed for: Fasting blood glucose, Fasting Lipid Profile, Serum Lipoprotein(a). Serum Lp(a) was estimated by immunoturbidimetry method and Lipid profile by enzymatic method. eGFR was calculated using MDRD formula and staging of CKD subjects was done based on NKF-K/DOQI guidelines. Novel Lipid Indices were calculated using appropriate formula. RESULTS: Statistical Analysis of the tabulated data was done using Excel software. There were significant differences in the levels of FBS, TG, Lp(a) between controls and predialysis CKD subjects (p<0.001). Among Lipid Indices, Atherogenic Index of Plasma(AIP) and Lipid Tetrad Index (LTI) values were significantly higher in CKD subjects compared to controls (p<0.001), but there was no significant difference was seen in Atherogenic coefficient (AC), Castelli’s Risk Index-I (CRI-I) and Castelli’s Risk Index-II (CRI-II) values. AIP and LTI showed significant positive correlation with Lp(a). LTI had the highest positive predictive value (77.8%) and negative predictive value (72.7%); AIP had PPV of 65.3% and NPV of 66.2%. CONCLUSION: The present study concludes that among lipid indices, AIP and LTI are the most suitable for assessment of atherogenicity in predialysis CKD. In developing countries like India, owing to high cost of tests like Serum Lp(a), novel lipid index AIP can serve as a cost effective screening tool for monitoring cardiovascular disease risk in CKD patients.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201423052 |
| Uncontrolled Keywords: | Chronic Kidney Disease, Lipoprotein (a), Lipid profile, Lipid indices (AIP, LTI, AC, CRI-I, CRI-II), Kidney Disease Outcomes and Quality Initiative (K/DOQI), Modification of Diet in Renal Disease (MDRD) formula, estimated GFR (eGFR). |
| Subjects: | MEDICAL > Biochemistry |
| Depositing User: | Subramani R |
| Date Deposited: | 20 Jul 2020 16:04 |
| Last Modified: | 20 Jul 2020 16:04 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12580 |
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