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Query: UMLS:C0020473 (
hyperlipidemia
)
15,891
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Muscle weakness and tenderness together with a rise in serum creatine kinase (C.K.) were noted in five uraemic patients treated with 1-2 g of clofibrate ('Atromid-S') daily. Excessive accumulation of both total and free serum chlorophenoxyisobutyric acid (C.P.I.B.), the active circulating metabolite after clofibrate therapy, was found in three patients in whom it was sought. It is suggested that
chronic renal failure
should be regarded as a contraindication to the use of clofibrate for the treatment of any coexisting
hyperlipidaemia
. If such therapy is contemplated it must be cautiously instituted at low dosage and the patient monitored by regular assessment of serum C.K. and levels of both total and free C.P.I.B.
...
PMID:Clofibrate-induced muscle damage in patients with chronic renal failure. 5
Since quantitative and qualitative alterations in plasma lipoproteins may provide insights into mechanism(s) of altered lipid transport in renal failure, whole plasma triglyceride (TG) and cholesterol (Chol) concentrations and lipoprotein neutral lipids and composition were examined in patients with
chronic renal failure
(undialyzed and dialyzed) and following successful renal transplantation. Both uremic groups demonstrated increased TG (p less than 0.001) and normal Chol in whole plasma and increased total TG and Chol in the very low-density lipoprotein fraction (VLDL). All hyperlipidemic subjects showed a Type IV phenotype. The percentage triglyceride in VLDL was slightly higher than control in the dialysis patients, and significantly increased in LDL in both undialyzed (p less than 0.001) and dialyzed (p less than 0.005) uremic groups. Transplant patients had significant increases (p less than 0.001) in both TG and Chol in whole plasma, and increased total TG and Chol in both the low-density lipoproteins (LDL) and VLDL fractions. Transplant patients with
hyperlipidemia
showed a variety of phenotypes and an enrichment of triglyceride in VLDL and LDL. These findings indicate that abnormalities in lipoprotein metabolism in renal failure patients are not appreciably affected by chronic dialysis treatment and continue following successful transplantation. The tendency toward increased VLDL and LDL triglyceride content in these patients resembles the lipoprotein neutral lipid composition found in nonrenal patients with similarly elevated plasma lipids. These alterations could result from primary disturbances in VLDL production and/or removal.
...
PMID:Effects of chronic uremia, hemodialysis, and renal transplantation on plasma lipids and lipoproteins in man. 17 66
Pancreatitis has been described previously following renal transplantation, but not in association with
chronic renal failure
. Analysis of 168 patients with renal transplants revealed five who developed pancreatitis, three of whom died. All five were on treatment with prednisone and azathioprine. Four patients were seen with definite attacks of pancreatitis and chronic, stable renal failure from a variety of causes. None had received immunosuppressive agents, prednisone nor thiazide diuretics, but two were on regular frusemide. One patient was on maintenance dialysis, which could not be related directly to the pancreatitis. In either group alcohol ingestion, cholethiathiasis, or hypercalcaemia was not a factor. This diagnosis of pancreatitis was established on clinical grounds and serum amylast levels of greater than 900 iu/1. Similar serum amylast elevation was not found ina random group of patients with
chronic renal failure
.
Hyperlipidaemia
was not present in any patient with pancreatitis. Although hypercalcaemia and primary hyperparathyroidism was not found in the transplant and non-transplant subjects, elevated serum parathormone levels have been described in uraemic patients with normocalcaemia. Hyperparathyroidism may be a factor in the development of pancreatitis in reanl failure. Pancreatitis carries a significant mortality risk in renal transplantation. The four non-transplanted patients have survived, despite recurrent attacks of pancreatitis.
...
PMID:Pancreatitis and renal disease. 31 21
The pharmacokinetics of the hypolipidemic agent, clofibrate have been studied in anuric patients on intermittent hemodialysis. In addition we have tried to determine whether the treatment of
hyperlipidemia
of
chronic renal failure
with clofibrate was safe and efficacious. Seven healthy volunteers and five uremic patients received a single dose of 25 mg/kg body weight of clofibrate. Mean peak plasma levels of clofibrate were comparable in both groups and were reached 3.5 hr after drug ingestion in the control subjects and after 6.5 hr in the uremic patients. The mean plasma half-life of clofibrate was 16.7 hr and 68.4 hr in the control subjects and in the patients, respectively (P less than 0.001). Following a short loading period a daily oral maintenance dose of 5 mg/kg body weight was given leading to a plasma clofibrate level of 75-100 microgram/100 ml. Five hyperlipidemic uremic patients received this dose for 3 months. Their plasma clofibrate and creatine kinase levels were constantly monitoried to detect clofibrate myotoxicity which we have observed in uremic patients at plasma levels generally considered safe in patients with normal renal function. Significant decreases in serum total lipid, triglyceride, and cholesterol levels were observed when compared to pretreatment values. In two of the 5 patients serum lipids remained decreased for 10 and 14 months. It is concluded that clofibrate treatment of
hyperlipidemia
in uremic patients, when carefully monitored, is safe and efficacious.
...
PMID:Clofibrate treatment of hyperlipidemia in chronic renal failure. 59 55
Fasting plasma concentrations of triglycerides (TG), cholesterol, immunoreactive insulin (IRI), and blood glucose were raised in 16 children with
chronic renal failure
on regular haemodialysis compared with 18 healthy children. In the patients plasma IRI correlated positively with plasma TG, while blood glucose did not correlate with IRI or lipid concentrations. Dietary intake, expressed as percentage of recommended intake for height-age, did not correlate with plasma lipids, but there was a positive correlation between plasma TG and the proportion of calories derived from carbohydrate. The children were not malnourished as evidenced by normal plasma albumin and transferrin concentrations. The mechanism of the
hyperlipidaemia
is unclear but it may be related to the glucose intolerance with hyperinsulinaemia which is found in uraemia. In view of the risk of premature atherosclerosis, plasma lipid concentrations should be monitored in children with
chronic renal failure
and attempts made to ameliorate
hyperlipidaemia
with appropriate dietary manipulations.
...
PMID:Hyperlipidaemia in children on regular haemodialysis. 60 69
Many alterations in metabolic and endocrine function occur in end-stage renal disease. Glucose intolerance is almost always present with uremia; it improves shortly after institution of regular hemodialysis.
Hyperlipidemia
(type IV) is prevalent, and atherosclerotic cardiovascular disease causes death in about 50% of patients receiving long-term hemodialysis. Although plasma levels of growth hormone usually are elevated, children with
chronic renal failure
show growth retardation. The occurrence of thyroid disorders is difficult to determine, since many clinical features of uremia are similar to those of hyperthyroidism and hypothyroidism. The incidence of duodenal ulcer is high, possibly due to high gastrin levels. Sex hormone disturbances are common. Anemia is a constant feature of
chronic renal failure
; patients usually tolerate it well.
...
PMID:Metabolic and endocrine alterations in end-stage renal failure. 71 39
Hyperlipaemia
persisted for more than 12 months in rats treated with cobalt chloride, 9 of 20 treated rats and 1 control rat died within the first year, and 8 of the surviving animals developed fibrosarcomas--in 4 of these the tumour was far removed from the injection sites. The results are discussed with reference to the use of cobalt chloride treatment for anaemia in patients with
chronic renal failure
.
...
PMID:Fibrosarcomas induced by cobalt chloride (CoCl2) in rats. 83 22
We report the case of a 5-year-old girl who died two years after onset of the idiopathic nephrotic syndrome, which failed to respond to treatment with corticosteroid and cyclophosphamide. Severe atherosclerotic changes were noted in both coronary arteries. Prolonged
hyperlipidemia
in patients with long-standing nephrotic syndrome may represent a major risk factor predisposing to premature coronary atherosclerosis in children who are also destined to develop
chronic renal failure
.
...
PMID:Premature coronary atherosclerosis in a 5-year-old with corticosteroid-refractory nephrotic syndrome. 90 86
In order to evaluate the degree and type of hearing loss in patients with
chronic renal failure
, 61 patients undergoing chronic hemodialysis were examined. Hearing threshold levels, adjusted for age and sex, demonstrated a significant high frequency deficit, which in some patients was noted early in the course of hemodialysis. Fluctuations in hearing were noted over single dialysis events but were transient and apparently independent of corresponding changes in Na, K, Ca, BUN, creatinine, glucose, mean blood pressure, and weight. Preliminary attempts to evaluate
hyperlipidemia
as a possible cause of hearing loss did not reveal any hearing deficit or gain as related to triglyceride or cholesterol levels. The data suggested other possible causes of observed auditory loss.
...
PMID:Hearing function and chronic renal failure. 94 7
The prevalence of coronary heart disease (58%) in 43 patients with analgesic nephropathy with moderate to severe
chronic renal failure
was significantly higher than in the general population of the same age and sex. Mean serum triglyceride concentration and mean diastolic blood pressure were significantly higher in the group with coronary heart disease (214 mg/dl and 102 mm Hg, respectively) than in the group without it (162 and 94). Serum triglyceride values correlated inversely with GFR, indicating that hypertriglyceridemia was largely due to associated
chronic renal failure
; a specific effect of analgesic abuse on prevalence of heart disease, noted by others, could not be assessed in the absence of GFR-matched controls. The prevalence of coronary heart disease was significantly higher (81%) in the group with combined
hyperlipidemia
(hypertriglyceridemia and hypercholesteremia) compared to the groups without it or with normal serum triglyceride concentrations (44 and 41%, respectively). Hypotryptophanemia (a possible cause of
hyperlipidemia
in the nephrotic syndrome) was present in 77% of patients.
...
PMID:Increased prevalence of coronary heart disease in analgesic nephropathy: relation to hypertension, hypertriglyceridemia and combined hyperlipidemia. 126 11
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