Dyslipidemia in nephrotic syndrome

Hippokratia 2000, 4(3):121-127

P. Pangidis


Dyslipidemia in nephrotic syndrome is closely related with the degree of proteinuria and hypoalbouminemia. On the other hand, the underlying glomerular pathologic lesion seems to play no important role.Increased levels of total cholesterol, triglycerides, phospholipids, Lp (a), LDL, IDL and often VLDL are found, whereas changes in HDL levels are still under discussion.The lipid metabolism disorders can be explained by multifactorial pathogenetic mechanisms, such as enhanced hepatic synthesis of lipoproteins, decreased or diverse lipoprotein catabolism and loss of a liporegulatory substance in the urine.Changes of lipoprotein levels are reversible, following disease-specific treatment. Drugs, such as nicotinic acid, cholic acid binders, fibric acid derivatives and HMG CoA reductase inhibitors (statins), are currently used. Nevertheless, the question: what treatment, to which patient, for how long, still remains controversial.