Effects of hemodialysis on serum lipids and phospholipids of end-stage renal failure patients

Patients with chronic renal failure undergoing periodic maintenance hemodialysis frequently present dyslipoproteinaemia which has been linked to the sharply increased risk of cardiovascular disease in these subjects. Reported defects on lipoprotein-related enzyme activities suggest a possible influence of hemodialysis not just to plasma lipid and lipoprotein levels but also to the composition of cell membranes. In this study, it was investigated whether the reported lipid abnormalities are accompanied by changes in serum phospholipids levels. Blood samples were obtained from 140 patients undergoing maintenance hemodialysis treatment and 122 normolipidemic healthy controls and analyzed for total serum phospholipids and their individual subclasses, as well as for total cholesterol and triglycerides, HDL-cholesterol and its subclasses. A significant decrease was observed in serum HDL cholesterol levels (p<0.001) and its subclasses, HDL2-cholesterol (p<0.01) and HDL3-cholesterol (p<0.01) in patients when compared with healthy controls. A critical increase in the serum triglyceride content (p<0.001) of patients was also observed. In addition, the serum levels of sphingomyelin (p<0.01) and diphosphatidylglycerol (p<0.001) were increased in the patient group, while the levels of phosphatidylcholine (p<0.01) and phosphatidylinositol (p<0.01) were significantly decreased in the patient group compared to healthy controls. In conclusion, this work clearly demonstrates that hemodialysis treatment contributes significantly to the dyslipidemic profile of end-stage renal failure patients by altering serum lipoprotein and phospholipids concentrations.