LIPID - LOWERING REGIMES IMPROVE OXIDATIVE STRESS, TRYPTOPHAN DEGRADATION IN HYPERCHOLESTEROLEMIA CHRONIC KIDNEY DISEASE PATIENT

Chronic kidney disease (CKD) is a global health problem. The prevalence of CKD in the Vietnamese population is increasing. The lipidemic disorder was evidenced as the cardiovascular risk factor in CKD patients. Oxidative stress indices, tryptophan degradation indices are endothelial biomarkers that have a relationship with CKD. The combination of EZE and statin is more effective in lipid disorders treatment than Statin monotherapy was recorded. Therefore, we conducted the study to discover the relationship between lipid-lowering regimes and oxidative stress, as well as tryptophan degradation improvement in CKD patients with hypercholesterolemia. With 12 months of treatment, we have the following results: patients with CKD stage 3-4 have demonstrated dyslipidemia, increased oxidation status, decreased antioxidant levels, and increased inflammation. Treatment with lipid-lowering therapies regardless of simvastatin alone or simvastatin/ezetimibe combination significantly improved lipid profiles, ameliorated oxidative stress status, and decreased inflammatory markers (Kyn level and Kyn/Trp ratio). An improvement in lipidemia parameters, oxidative stress, and inflammation, in the group treated by Simvastatin 40 mg + Ezetimibe 10 mg daily appeared to be better. The improvement in inflammation was partly explained by a decrease in LDL-C through a decrease in oxidative stress. All patients did not show clinical signs of jaundice, myalgia, rhabdomyolysis as well as unchanged in SGOT, SGPT, and CK levels. Lipid-improving therapies do not improve kidney function nor worsen it. In summary, for CKD patient stage 3-4, who do not achieve an LDL-C target, Simvastatin/Ezetimibe at a dose of 40/10mg daily is suggested without causing dose-related side effects amount.