CKD

CKD* USRDS 1998**JSDT2000** 1999

******CKD10.9%NDCKD2132.020.68.0ESRD3.0%7.0%10.0%$100$10048

NHANES NKFK/DOQI CKD15>20 200011-22"CKDUSRDS, 2007 Annual Data Report13.1715.8310.9613.82

40CKD 402353 2310

CKD9.4 6.2 0.87 GFR 3.0

8.3,200622(2):67-71

202213

2128CKDl0.1

6.2 6.5 GFR 1.6

9.7CKD 2007 23 (3)

CKD201855 1752

CKDl3.63 5.80 8.23 GFR 1.29

8.27

,200824(9)

CKDAm J Kidney Dis 32:S142-S156,1998(suppl 3)

60-9030-5915-29GFR(ml/min/1.73m2)Curr Opin Nephrol Hyperten 1996; 5:141-146

,,.

,.

,.

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Bonnie C.H. Kwan,et al. Lipoprotein Metabolism and Lipid Management in Chronic Kidney Disease. J Am Soc 2007, 18: 12461261.

CM Chan,1MBBS, MRCP (UK), FAMS. Hyperlipidaemia in Chronic Kidney Disease. Annals Academy of Medicine; January 2005, Vol. 34 No. 1.

, ,., 2007,30(4):401-402.,2006,19(3):256-257.

CKDCKD

CKD:

LDL

LDL LDL(OX-LDL)VLDL LDLLDL,

KimLDL,

LDLVLDLNONO

LDLLDL

1. IL-1TNFLDLLDLLDL

VLDL Crook ED, et a1. Am J Medical Science,2003,325(6):340-348Feldstein AE,et a1.Hepatology,2004,40(1):185-194. Trevisan R, et a1. J Am Soc Nephrol,2006,17(4):s145-147.

2.HDL

3.

4.

Crook ED, et a1. Am J Medical Science,2003,325(6):340-348Feldstein AE,et a1.Hepatology,2004,40(1):185-194. Trevisan R, et a1. J Am Soc Nephrol,2006,17(4):s145-147.

: :

:

CKD CKD ,

CKD 18 240-242HDLCKD

CKD,,70%,Ch TGLDL,HDL.

.

(LPL,LCAT)LDL

CRF

CAPD,CAPD

-

2004

51.38%48.62%45.97%54.03%

CKD

, ,

, ,

7-15%,

:LDL-C, HDL-C,TG(?) :FH ()FCH ():: :

(Cholestyramine)4-5g1-6d24gl-3(Cholestipol)10-20g1-2d(Divistyramine)612gd

VLDL TGVLDL-CIDL-C; LDL-C(?),HDL-C(?) I ALT/AST -NSAID

(Niacin)l-2g3d370.1-0.5g4d1-2g3d(Acipimox) 0.25g3d(lnositolHexanicotinate)0.2g0.6g3d

VLDL/ TGVLDL-CIDL-C; HDL-C , LDL-C (?) III IV FCH (CK(Betteridge?)

(Clofibrate) 0.25-0.5g3d(Bezafibrate) 0.2g3d(Fenofibrate)0.1g3d(Etofylline Clofibrate) 0.25g2-3d(Gemfibrozil) 0.6g2d0.6g0.3g(Lifibrate) 50mg3d(Alufibrate)0.5g3d(Simfibrate)0.5g3d

(lovastatin) 10-80mg/d, (simvastatin) 5-80mg/d , (pravastatin) 10-40mg/d, (fluvastatin) 20-80mg/d, (atorvastatin) 10-80mg/d,

Mason RP et al. Am J Cardiol. 2005;96(suppl):11F

++++++++++, , Corsini A et al. Pharmacol Ther. 1999;84:413-428.

4,4-[(1-)()]-[2,6-(1,1-)](Probucol)C31H48O2S2516.85

TG ,VLDL;LDL-C (?), HDL-C (?)

-3(EPA)(DHA)

1.8g3d 0.45g0.9g3d 43d

CKD

GFRml/min/1.73m2 ) 60-90 15-19

ND: USRDSPercent of patients NHANES NKFK/DOQIUSRDS 2007 Annual Data Report2007K/DOQI50%85%LDL50%HDL60%30%10%LDL35%HDL40%

GFR6090GFR59GFR29

C(TG)LDL-CHDL-C)4TCLDL-CHDL-CTGParameter,,;incras,GeneralPopulition:;CKD with ne-:CKD;CKD without ne-:CKD\\,.:CM()\VLDL()\IDL()\ LDL\HDL\LDL\HDL\LDL\HDL

LDLLDL(OX-LDL)VLDLLDLKimLDLLDLLDLVLDLNONO

LDLLDL(OX-LDL)VLDLLDL

LDLLDL(OX-LDL)VLDLLDL LDLLDL(OX-LDL)VLDLLDL LDLLDL(OX-LDL)VLDLLDL LDLLDL(OX-LDL)VLDLLDL1LDL LDL(OX-LDL)VLDL VLDLLDL2KimLDLLDL3LDLVLDLNONO 4 5LDLLDL

LDLLDLA1A1HDL

apoB, Apo B100Apo B48Apo B100VLDLIDLLDL, 25%60%95%Apo B48CM, 5%Apo B0.801.00g/L () VLDL() Apo B100VLDL() Apo B100VLDLIDLLDL, () 80%LDL, Apo B100LDL() Apo B48CM,

A:,,LDL,LDL