Lipidic Profiles of Patients Starting Peritoneal Dialysis Suggest an Increased Cardiovascular Risk Beyond Classical Dyslipidemia Biomarkers

Background. Lipids are molecules that constitute a fundamental part of the plasma. Chronic kidney disease (CKD) produces profound changes in lipid metabolism, and associated lipid disorders, in turn, contribute to the progression of CKD. Patients on peritoneal dialysis (PD) have more atherogenic lipid profiles than non-dialysis-dependent CKD patients. Methods. Single-center prospective observational study of a cohort of CKD patients who started renal replacement therapy with continuous ambulatory peritoneal dialysis. The differences in the lipid profile and analytical variables before and six months after the start of peritoneal dialysis were analyzed. Samples were analyzed on an Ultra-Performance Liquid Chromatography system. Results. Thirty-nine patients were enrolled in this study. Their mean age was 57.9 ± 16.3 years. A total of 157 endogenous lipid species of 11 lipid subclasses were identified. There were significant increases in total free fatty acids (p< 0.05), diacylglycerides (p <0.01), triacylglycerides, (p <0.01), phosphatidylcholines (p <0.01), phosphatidylethanolamines (p <0.01), ceramides (p <0.01), sphingomyelins (p <0.01), and cholesterol esters (p<0.01) from baseline to 6 months. However, there were no differences in the classical lipid markers, neither lysophosphatidylcholines, monoacylglycerides, and sphingosine levels. Conclusions. Patients on PD present changes in the lipidomic profile beyond the classic markers of dyslipidemia, that suggest an increased cardiovascular risk in them.