International Journal of Medical Sciences

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22 October 2017

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Int J Med Sci 2014; 11(4):381-388. doi:10.7150/ijms.7069

Research Paper

The Impact of Chronic Kidney Disease on Lipid Management and Goal Attainment in Patients with Atherosclerosis Diseases in Taiwan

Tsung-Hsien Lin1,2✉, Shao-Yuan Chuang3, Chun-Yuan Chu1, Wen-Hsien Lee1, Po-Chao Hsu1,2, Ho-Ming Su1,2, Yi-Heng Li4, Ching-Chang Fang5, Kuo-Yang Wang6, Wei-Kung Tseng7, Ai-Hsien Li8, Kwo-Chang Ueng9, I-Chang Hsieh10, Lien-Chi Huang11, Chiun-Hsiung Wang12, Wen-Harn Pan3, Hung-I Yeh13, Chau-Chung Wu14, Wei-Hsian Yin15, Jaw-Wen Chen16✉

1. Division of Cardiology, Department of Internal Medicine; Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;
2. Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
3. National Health Research Institute, Chunan, and Academia Sinica, Taipei, Taiwan;
4. Division of Cardiology, National Cheng Kung University Hospital, Tainan, Taiwan;
5. Division of Cardiology, Tainan Municipal Hospital, Tainan, Taiwan;
6. Division of Cardiology, Taichung Veterans General Hospital, Taichung, Taiwan;
7. Division of Cardiology, E-DA Hospital, Kaohsiung, Taiwan;
8. Division of Cardiology, Far Eastern Memorial Hospital, Taipei, Taiwan;
9. Faculty of Medicine, Chung Shan Medical University, Taichung, Taiwan;
10. Division of Cardiology, Linkou Chang Gung Memorial Hospital, Taipei, Taiwan;
11. Division of Cardiology, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan;
12. Division of Cardiology, Taipei City Hospital Renai Branch, Taipei, Taiwan;
13. Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan;
14. Department of Primary Care Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan;
15. Division of Cardiology, Heart Centre, Cheng-Hsin General Hospital, and Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan;
16. Division of Cardiology, Taipei Veterans General Hospital, and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.

Abstract

Background: Patients with chronic kidney disease (CKD) is a very high risk cardiovascular disease population and should be treated aggressively. We investigated lipid management in CKD patients with atherosclerosis in Taiwan.

Methods: 3057 patients were enrolled in a multi-center study (T-SPARCLE). Lipid goal are defined as total cholesterol (TC) < 160mg/dl, low-density lipoprotein (LDL) <100 mg/dl, high-density lipoprotein (HDL) > 40 mg/dl in men, HDL > 50 mg/dl in women, non-HDL cholesterol < 130mg/dl, and triglyceride < 150 mg/dl.

Results: Compared with those without CKD (n=2239), patients with CKD (n=818) had more co-morbidities (hypertension, glucose intolerance, stroke and heart failure) and lower HDL but higher triglyceride levels. Overall 2168 (70.5%) patients received lipid-lowering agents. There was similar equivalent statin potency between CKD and non-CKD groups. The goal attainment is lower in HDL and TG in the CKD group as compared with non-CKD subjects (47.1 vs. 51.9% and 63.2 vs. 68.9% respectively, both p < 0.02). Analysis of sex and CKD interaction on goals attainment showed female CKD subjects had lower non-HDL and TG goals attainment compared with non-CKD males (both p < 0.019).

Conclusion: Although presenting with more comorbidities, the CKD population had suboptimal lipid goal attainment rate as compared with the non-CKD population. Further efforts may be required for better lipid control especially on the female CKD subjects.

Keywords: lipid, chronic kidney disease, goal, atherosclerosis.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Lin TH, Chuang SY, Chu CY, Lee WH, Hsu PC, Su HM, Li YH, Fang CC, Wang KY, Tseng WK, Li AH, Ueng KC, Hsieh IC, Huang LC, Wang CH, Pan WH, Yeh HI, Wu CC, Yin WH, Chen JW. The Impact of Chronic Kidney Disease on Lipid Management and Goal Attainment in Patients with Atherosclerosis Diseases in Taiwan. Int J Med Sci 2014; 11(4):381-388. doi:10.7150/ijms.7069. Available from http://www.medsci.org/v11p0381.htm