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CHOLESTEROL AND CHRONIC KIDNEY
DISEASE
What is cholesterol?
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.
Why is cholesterol important?
Too much cholesterol can build up in your
blood vessels. This build up can narrow 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.
In people with chronic kidney disease (CKD),
heart 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.
What tests are used to measure cholesterol?
Low density lipoprotein (LDL) cholesterol,
also known as bad cholesterol, is the primary cholesterol test used
to screen for heart 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.
Cholesterol lab values are different for
adults and children. The lab ranges stated below are for adults and
should not be used for children. People with good LDL cholesterol,
high HDL cholesterol, and normal triglycerides are less likely to
have heart disease.
| |
LDL
Cholesterol
|
HDL
Cholesterol
|
Total
Cholesterol
|
Triglycerides
|
| |
Optimal <100mg/dL |
>60mg/dL
F >55mg/dL M |
Desirable
<200mg/dL |
Normal <150mg/dL |
| Near Optimal |
100-129mg/dL |
|
|
|
| Borderline High |
130-159mg/dL |
|
200-239mg/dL |
150-199mg/dL |
| High |
160-189mg/dL |
<40mg/dL* |
>240mg/dL |
200-499mg/dL |
| Very High |
>190mg/dL |
|
|
>500mg/dL |
*Values below 40 mg/dL are considered low for
HDL.
What other items are used to measure risk for
heart disease?
Aside from high LDL cholesterol levels, the
risk for heart disease increases with the following risk factors:
- cigarette smoking
- obesity
- high blood glucose
- low HDL cholesterol
- age (men > 45 years old; women > 55 years
old)
- high blood pressure or on antihypertensive
medications
- diabetes mellitus
- family history of early heart disease
- other forms of vessel narrowing diseases.
People with CKD may have some added risk
factors that lead to heart disease:
- large calcium intake from diet or
medication
- high blood phosphorus levels
- high parathyroid hormone levels
- high homocysteine levels
- whole body inflammation.
People who are physically inactive or who eat
foods that are high in saturated fat and cholesterol are also at
risk for developing heart disease.
What can I do to decrease my risk for heart
disease?
Lifestyle Changes:
- Increase physical activity to 30 minutes
every day at a moderate level. This will help:
- raise HDL cholesterol
- lower LDL cholesterol in some people
- lower blood pressure
- improve diabetic control
- improve heart function.
- Obtain and maintain a healthy weight
- Talk to your doctor and dietician
- Do not smoke.
- Do not drink alcohol excessively. (Limit
alcohol to 1 drink a day with physician approval.)
Diet changes:
Choose foods that are low in saturated fat
and cholesterol. See "Tips to reduce fat and cholesterol in your
diet."
Decrease use of trans fatty acids since they
can raise LDL cholesterol.
Use plant stanols and sterols found in
regular or "light" specially formulated margarine-like spreads.
Increase soluble fiber. (Fruits and vegetables and grains are good
sources of fiber.)
Talk with your dietician for assistance with
safely and gradually increasing fiber in your diet.
Treatment of Other Risk Factors:
- Control hypertension and diabetes.
- Treatment for these diseases can include
medications, diet changes and increased physical activity.
- Your doctor and dietitian can help you with
lifestyle changes to best treat these diseases.
What about medications to help lower my risk
for heart disease?
Medications are available for lowering LDL
cholesterol and triglycerides, but heart disease medications work
the best when diet and life style changes have already been made.
Who can I talk to about specific questions I
have to reduce my risk for heart disease?
- Your doctor can talk to you about how best
to treat your risk for heart disease.
- A pharmacist can answer questions you might
have about any medications the doctor has prescribed for you.
A dietician can help you in making healthy
food changes to your diet.
Tips to Reduce Fat and Cholesterol in Your
Diet
- Choose lean meats, poultry and fish. The
loin and round cuts of meat tend to be leaner than rib cuts and
organ meats.
- Trim all visible fat from meat and remove
skin from poultry.
- Steam, broil, roast or bake meat, poultry
and fish. Place the food on a rack to allow the fat to drain away
from the food. Do not fry foods.
- Choose fresh fruits and vegetables. Steam,
boil, bake or microwave vegetables. Do not fry foods.
- Use nonstick pans or vegetable sprays for
sautéing.
- Use herbs and spices to season foods
instead of sauces, butter or margarine.
- Try wine, lemon juice, or flavoured vinegar
to give flavour with limited fat and calories.
- Use jelly, jam, honey or syrup instead of
butter or margarine on toast, waffles, pancakes or muffins.
- Use fat free or reduced fat versions of
high-fat foods. For example, use fat-free sour cream in place of
regular sour cream or use 1% or skim milk in allowed amounts.
- Limit hydrogenated and partially
hydrogenated fats. These can be found in some margarines, peanut
butters, packaged baked goods and snacks, and fried foods. Try
baked crackers instead of fried crackers. Buy grilled or baked
items when eating out.
- Use two grams of plant stanols or sterols
per day. These are sold as specially formulated margarine-like
spreads. Your dietician can assist you with finding these
products.
- Limit products made with coconut, palm
kernel, palm oil, lard, shortening, bacon fat and cocoa butter.
- Use canola or olive oils instead of
shortening, butter or other oils when cooking. These
monounsaturated fats will not lower your HDL level.
- Try sherbet or ice milk instead of ice
cream.
- Read food labels on the foods you buy. Do
not be misled by foods that are cholesterol free but contain large
amounts of saturated fat that your body will turn into
cholesterol.
References:
American Journal of Kidney Diseases, Vol 41, No 4, Suppl 3
(April), 2003: pp S1-S91.
National Institutes of Health, National
Cholesterol Education Program Publication No. 01-3670, May 2001.
Journal of Renal Nutrition, Vol 8, No 3
(July), 1998: pp 160-161.
AFREKID, a major voluntary health
organization, seeks to prevent kidney and urinary tract diseases,
improve the health and well-being of individuals and families
affected by these diseases, and increase the availability of all
organs for transplantation. Through its 50 affiliates nationwide,
the foundation conducts programs in research, professional
education, patient and community services, public education and
organ donation.
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See also in this A-Z guide:
- Dining Out With Confidence
- Nutrition and Chronic Kidney Disease
- What You Should Know About Blood Lipids
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