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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Undertreatment of hyperlipidemia in a cohort of United States kidney dialysis patients
Clinical Nephrology, Volume 61, No. 5, Year 2004
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Description
Background: Application of national guidelines regarding cardiovascular disease risk reduction to kidney dialysis patients is complicated by the conflicting observations that dialysis patients have a high risk of atherosclerotic cardiovascular disease (ASCVD), but dialysis patients with higher serum cholesterol have lower mortality rates. Actual treatment patterns of hyperlipidemia are not well studied. Methods: We assessed the prevalence, treatment and control of hyperlipidemia in this high-risk patient population from 1995 - 1998. We measured low density lipoprotein cholesterol, treatment with a lipid-lowering agent, and prevalence of hyperlipidemia as defined by the National Cholesterol Education Program (NCEP), Adult Treatment Panel (ATP) II guidelines in 812 incident hemodialysis (HD), and peritoneal dialysis (PD) patients from dialysis clinics in 19 states throughout the United States. Results: Hyperlipidemia was present in 40% of HD and 62% of PD patients. Among subjects with hyperlipidemia, 67% of HD and 63% of PD patients were untreated and only 22% of HD and 14% of PD patients were treated and controlled. Those who entered the study in 1997 or 1998, those with diabetes, males and Caucasians were more likely to be treated and controlled, whereas subjects on PD and those with ASCVD were less likely to be treated and controlled. Conclusion: These data suggest that high rates of undertreatment exist in the United States ESRD dialysis population. Whether improved rates of treatment will result in decreased cardiovascular disease events needs to be tested in randomized clinical trials. © 2004 Dustri-Verlag Dr. K. Feistle.
Authors & Co-Authors
Fox, Caroline S.
United States, Baltimore
Welch Center for Prevention Epidemiology and Clinical Research
United States, Framingham
Framingham Heart Study
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Longenecker, Joseph Craig
United States, Baltimore
Welch Center for Prevention Epidemiology and Clinical Research
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Kuwait, Kuwait City
Kuwait University
Powe, Neil R.
United States, Baltimore
Welch Center for Prevention Epidemiology and Clinical Research
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Klag, Michael J.
United States, Baltimore
Welch Center for Prevention Epidemiology and Clinical Research
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Fink, Nancy E.
United States, Baltimore
Welch Center for Prevention Epidemiology and Clinical Research
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Parekh, Rulan S.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Coresh, Josef
United States, Baltimore
Welch Center for Prevention Epidemiology and Clinical Research
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Sadler, John H.
Unknown Affiliation
Anderson, Gerard
Unknown Affiliation
Bass, Eric B.
Unknown Affiliation
Briggs, William
Unknown Affiliation
Brookmeyer, Ron S.
Unknown Affiliation
Meyer, Klemens
Unknown Affiliation
Levey, Andrew S.
Unknown Affiliation
Levin, Nathan W.
Unknown Affiliation
Rubin, Haya R.
Unknown Affiliation
Whelton, Paul Kieran
Unknown Affiliation
Wu, Albert W.
Unknown Affiliation
Statistics
Citations: 24
Authors: 18
Affiliations: 4
Identifiers
Doi:
10.5414/CNP61299
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study