Dynamics of lipid profile in patients with end-stage renal disease depending on the class of antihypertensive drugs

The aim of the study is to evaluate the effect of antihypertensive therapy on lipid metabolism parameters in patients undergoing maintenance hemodialysis (MHD). Materials and methods. A three-year observational study was conducted involving 719 patients undergoing maintenance hemodialysis (MHD). Subgroups were formed based on the antihypertensive therapy received: calcium channel blockers (CCBs: lercanidipine, amlodipine; n=120), renin-angiotensin-aldosterone system blockers (RAASBs: ramipril, perindopril, valsartan, telmisartan, candesartan, azilsartan; n=49), beta-blockers (BBs: bisoprolol, metoprolol; n=47), CCBs + BBs (n=104), BBs + RAASBs (n=34), CCBs + imidazoline receptor agonist (IRA: moxonidine; n=56), and CCBs + RAASBs (n=81). Lipid profiles were evaluated in all patients. Results. Patients receiving BBs exhibited a decrease in the atherogenic index (AI, p<0.05) and an increase in high-density lipoprotein cholesterol (HDL-C, p<0.01) levels. BB therapy was an independent predictor of lower low-density lipoprotein cholesterol (LDL-C, p<0.001). No statistically significant changes were observed during RAASB therapy. Patients receiving CCBs showed a decrease in TG levels (p<0.001). At the same time there was an increase in LDL-C (p<0.05) and AI (p<0.05). Combined CCB + IRA therapy was associated with higher AI, LDL-C, and non-HDL-C levels (p<0.05). CCB + IRA or CCB + RAASB therapies were associated with a less favorable lipid profile (increased AI and non-HDL-C) compared to CCB + BB therapy (p<0.01). BB + CCB or BB + RAASB therapies reduced TC, HDL-C, and non-HDL-C levels (p<0.05). Conclusion. In hemodialysis patients, the use of CCBs, both as monotherapy and in combination, was associated with more pronounced lipid profile disturbances. BB therapy was associated with a reduction in atherogenicity, while RAASB treatment did not lead to significant changes in the lipid profile.