Cholesterol. If you are over the age of 35, I will bet you know your number- or dread the number and refuse to acknowledge it. But…
As I’ve written before, cholesterol is just a surrogate measurement. What’s that you say? I mean that our blood cholesterol levels per se means absolutely nothing. We use the levels of cholesterol in our blood to indicate whether there is a chance of heart disease and complications.
It doesn’t help that we (think we) have two types of cholesterol in play. Good (HDL- or high density lipoprotein cholesterol) and Bad (LDL or low density lipoprotein cholesterol). I’m sure you noticed my extra caveat.
Dr. Robert Krauss (Oakland Research Institute, Children’s Hospital) has been doing research on cholesterol. Because he noticed that there are four different types of bad cholesterol (which he distinguishes by ion mobility analysis)- large, medium, small, and very small. And, it turns out that it’s the smaller, denser versions of LDL that seem to have a much better correlation to heart disease than LDL in general. Especially if these folks have low levels of good (HDL) cholesterol.
That is probably why folks who take drugs to lower their cholesterol- and actually obtain lower blood levels- still manifest heart problems. And, those who don’t take drugs and have lower levels of LDL still die of heart disease.
Normally, HDL has heart protective effects (that’s why it’s called good cholesterol). HDL binds toxic substances found in the blood and can help excess cholesterol be excreted from the body. But, these effects are not manifested by those on dialysis- and that is true for both peritoneal and hemo-dialysis.
These were the facts as depicted in a new article published in the Journal of the American Society of Nephrology. . Drs. M. Holzer, G. Schilcher, S. Curci, M. Trieb, S. Ljubojevic, T. Stojakovic, H. Scharnagl, A. Rosenkranz, A. Heinemann, and G. Marsche (Medical University of Graz, Austria) with Dr. C. Kopecky (Medical University of Vienna, Austria) collaborated in this research “Dialysis Modalities and HDL Composition and Function”.
This may explain (even though it is just a surrogate market) why folks on dialysis may have associated problems with circulatory and heart disease. Or not. But, the goal of increasing good cholesterol levels is probably not a worthwhile endeavor for those on dialysis.
We’ll continue these discussions over the next few posts…
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