DYSLIPIDAEMIA IN CHILDREN ON DIALYSIS AND AFTER KIDNEY TRANSPLANTATION

Cardiovascular complications are the main problems associated with end stage renal disease (ESRD) in adult, which began renal replacement therapy (RRT) in childhood. One of the factors contributing to this can be an imbalance of blood lipids. Aim of the study was to evaluate changes in the lipid profile in children with ESRD, depending on the RRT method and age, and also after kidney transplantation depending on the glomerular filtration rate. Materials and methods. In 91 children with ESRD at the age of 2–17 years who received peritoneal dialysis (PD) or hemodialysis (HD), or after kidney transplantation (Tx), total cholesterol (CH), triglycerides (TG), lipoproteins high density (HDL) ) were measured in 663 samples of blood and calculated fraction of non–HDL (CH – HDL). Dyslipidemia was defined as TG>1,13 mmol/1 (0–9years) and >1,47mmol/l (10–17years), CH> 5,18mmol/l, non–HDL >3,7mmol/l, HDL <1.0 mmol/l. Results. The prevalence of dyslipidemia in children was 90,4% on PD, 65,2% on HD and 32,6% after Tx, mainly due to hypertriglyceridemia in 80,8% on PD, 65,2% on HD and 20,8% after Tx. The levels ofTG and non–HDL were also significantly higher in PD and HD patients than after Tx. Children of the younger age group (2–5 years) on PD had the worst lipid profile. After kidney transplantation a significant reduction of TG and cholesterol was detected in PD patients and only TG in HD patients. Reduction of the glomerular filtration rate in children after kidney transplantation is accompanied by an increase in TG levels. Conclusion. Dyslipidemia is widespread in children on RRT. Preemptive kidney transplantation can prevent the development of severe lipid imbalance which persists of dialysis treatment.