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Kidney Week

Abstract: TH-PO624

Characteristics of Dyslipidemia in Primary Nephrotic Syndromes

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Alhumaid, Sulaiman Mohammed, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia
  • Alhamzah, Hamzah Ali, Imam Muhammad Ibn Saud Islamic University, Riyadh, Riyadh, Saudi Arabia
  • Almagooshi, Ali Sulaiman, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia
  • Samman, Ahmad Mohammad, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia
  • Alqaraishi, Ali Mohammad, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia
  • Alqudsi, Muhannad, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia
Background

Although it is not a criterion for diagnosis, dyslipidemia is frequently found in nephrotic syndrome (NS). Cholesterol, triglyceride, and low-density lipoprotein (LDL) are usually elevated in NS, while high-density lipoprotein (HDL) can be normal or minimally decreased. Mechanisms, treatments, and related medical outcomes of dyslipidemia in NS have been studied in isolation of the underlying disease, hence the comparison of lipid values between primary membranous nephropathy (MN), minimal change disease (MCD), and primary focal segmental glomerulosclerosis (FSGS), is not well recognized.

Methods

Retrospective chart review of patients with NS from 2010-2022. Only patients with primary MN, MCD, and primary FSGS were included. Lipid profile was reported at the time of NS diagnosis and twelve months later. We compared lipid values between three primary NS using Kruskal-Wallis and Mann-Whitney U tests.

Results

There were 409 patients diagnosed with NS. 284 patients were excluded due to insufficient data, secondary NS, or uncontrolled DMII (glycated hemoglobin A1C>8). 125 patients with primary FSGS, MN, or MCD were included. 52=FSGS (41%), 31=MCD (25%), 42=MN (34%). Average age was 32 years, 55=Females (44%), 25=Diabetes Mellitus (DM) (20%), 79=received statin (56%), there was no statistical difference in baseline characteristics between NS groups. After adjustment to serum albumin and urine protein/creatinine ratio, initial cholesterol and triglyceride were similar in three NS groups (P>0.05), LDL was 216 mg/dL, 201 mg/dL, and 178 mg/dL in FSGS, MCD, and MN respectively p= 0.04 (statistical difference was only in FSGS vs MN group p=0.04), initial HDL was 58 mg/dL, 77 mg/dL, and 50 mg/dL in FSGS, MCD, and MN respectively p=<0.001 (statistical differences were in MCD vs FSGS, and MCD vs MN groups p=0.001, and p=<0.001 respectively). After 12 months follow up, all lipid values were similar in three NS groups regardless of statin use.

Conclusion

After adjustment to primary NS severity, cholesterol and triglyceride values are not significantly different at presentation of MN, MCD, and FSGS. HDL is significantly higher in MCD compared to MN, and FSGS. LDL is significantly higher in FSGS compared to MN. At 12 months follow up, use of statin did not change lipid values in MN, MCD, or FSGS.