title: Effect of lifestyle changes and atorvastatin administration on dyslipidemia in hemodialysis patients: a prospective study.
abstract: BACKGROUND
  Atherogenic dyslipidemia accelerates the development of cardiovascular complications and contributes to mortality of hemodialysis (HD) patients.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the effects of lifestyle changes followed by treatment with atorvastatin in dyslipidemic HD patients.
  
  
  METHODS
  Dyslipidemic HD patients (n = 49) were enrolled into the prospective study. Forty-two patients completed a 21-week lifestyle intervention. In 34 patients, who continued to be dyslipidemic, atorvastatin was used for 14 weeks. After 4 weeks, the initial dose of atorvastatin of 10 mg/d was increased to 20 mg/d in dyslipidemic patients.
  
  
  RESULTS
  The most pronounced effects of lifestyle changes were shown at 14 weeks and included significant differences in high-density lipoprotein cholesterol, low-density lipoprotein (LDL) cholesterol, salusin α, malondialdehyde-oxidized LDL, fructosamine, and monocyte CD36 expression. Immunoglobulin G anti-oxLDL showed the highest values at 21 weeks. Seven patients (16.7%) were nondyslipidemic at 21 weeks. In patients who continued to be dyslipidemic, LDL cholesterol and triglyceride levels significantly decreased, salusin α levels and CD36 expression increased, and dyslipidemia resolved in 59.4% of the patients following atorvastatin treatment.
  
  
  CONCLUSIONS
  Lifestyle changes have selective efficacy in the treatment of dyslipidemia in HD patients, while atorvastatin (up to 20 mg/d) may be effective in about 60% of nonresponders to lifestyle changes. Lipid-lowering interventions affect plasma salusin α and monocyte CD36 expression.
authors.forename: Alicja E
authors.initials: AE
authors.lastname: Grzegorzewska
authors.forename: Leszek
authors.initials: L
authors.lastname: Niepolski
authors.forename: Jan
authors.initials: J
authors.lastname: Sikora
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Janków
authors.forename: Paweł P
authors.initials: PP
authors.lastname: Jagodziński
authors.forename: Anna
authors.initials: A
authors.lastname: Sowińska
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D002784:Cholesterol / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D002784:Cholesterol; D000069059:Atorvastatin