High Cholesterol = High Kidney Disease Risk

Abnormal cholesterol levels are a hazard to the kidneys, according to the Physicians' Health Study. This study has been following about 4500 men for 14 years. People with high total cholesterol or reduced HDL (“good”) cholesterol were more likely to have reduced glomerular filtration rate (GFR). This is the best way to assess kidney function. A GFR of 60 or lower usually means chronic kidney disease. In fact, people with cholesterol problems were twice as likely to have chronic kidney disease over time.

This raises the possibility that one way to slow the onset of chronic kidney disease would be controlling a person's cholesterol levels. Prevention is important because kidney disease is a serious and growing problem both in terms of lives lost, losses in quality of life, and costs of treatment. If kidney disease isn't slowed down or stopped, many more people will need renal replacement therapy in the form of kidney transplantation or dialysis.

Cholesterol is a fat-like substance found in your blood. Your body can make cholesterol as well as get it from eating meats and other animal food products.

Too much cholesterol can build up in your blood vessels. This build up can narrow the vessels and lead to a blockage, preventing blood from getting to a certain area of your body. When this occurs in your heart vessels, it is called coronary heart disease and can cause a heart attack or stroke.

In people with chronic kidney disease (CKD), heart and blood vessel disease is very common. It is suggested that people with CKD have cholesterol labs drawn at least yearly. Your doctor may want to do them more frequently if something has changed with your health.

Cholesterol is the main lipid. It is made up of different parts such as:

• LDL cholesterol, or “bad” cholesterol, the main lipid that causes damaging buildup and blockage in your arteries.
• HDL cholesterol is actually a “good” type of cholesterol that helps to prevent cholesterol from building up in your arteries.
• Triglyceride is another lipid that may increase your risk for heart disease.

Low density lipoprotein (LDL) cholesterol, also known as bad cholesterol, is the primary cholesterol test used to screen for heart and blood vessel disease. Other lab tests usually drawn are high density lipoprotein (HDL) cholesterol, also known as good cholesterol, triglycerides, and total cholesterol.

Since these tests are affected by food, it is recommended that you should not eat nine to 12 hours before the lab tests are drawn.

• Your total cholesterol should be less than 200.
• Your HDL cholesterol should be 40 or higher.
• Your LDL cholesterol should be less than 100. Ask your doctor.
• Your triglyceride level should be less than 150.

Guidelines for treating problems with cholesterol emphasize lifestyle changes.
These are:

• Increase physical activity to 30 minutes every day at a moderate level
• Obtain and maintain a healthy weight
• Talk to your doctor and dietitian about how to improve your food choices
• Do not smoke
• Do not drink alcohol excessively (limit alcohol to 1 drink a day with physician approval)

• Pick fruits, vegetables, low-fat dairy products, and whole grains
• Limit salt, red and processed meats, and sweetened beverages
• Choose foods that are low in saturated fat and cholesterol
• Decrease use of trans-fatty acids since they can raise LDL cholesterol
• Increase soluble fiber (fruits and vegetables and grains are good sources of fiber)

Medications are available for lowering LDL cholesterol and triglycerides, but these medications work best when lifestyle changes have already been made. There is evidence that certain medicines called statins can slow the process of both chronic kidney disease and heart disease. These drugs are used to lower high cholesterol levels in the blood, helping slow down the progression of chronic kidney disease.