Cholesterol and CKD

[drmind]

Does anyone have any experience or information about high cholesterol and kidney damage.

[orangecity41 NKF Ambassador]

I have had high cholesterol for a long time but have not been told it is connected to CKD. With a non statin medicine and fish oil, is under control and within range.

[drmind in reply to orangecity41]

Thanks for your reply. What's the non-statin medication? Cardiolgist's PA recommended I try Vascepa but first check with kidney doctor. Kidney doctor wants me to try diet for the next three weeks and then evaluate the results. If results are not better, his recommendation is a very low dose of Lipitor. My cholesterol levels all went downfrom the last labs several months ago based on diet, but the levels are still very high.

I had problems with Lipitor in the past and he's aware of that . About the cardiologist's consult and Echo results: no problems found and I do not have to return for any visits. So happy with that! Phew, at least there's one thing that has a benefit from the food I eat. GFR remained in CKD 4 at 25 down from 29. I'm aware that this number is just a momentary item, but it would have been nice to get back into CKD 3.

BTW: There are some links to high cholesterol and kidney disease.

Best to all.

[orangecity41 NKF Ambassador in reply to drmind]

I was prescribed ezetimibe (Zetia is the brand name). It may not work for everyone. "Ezetimibe is used along with a low cholesterol/low fat diet and exercise to help lower cholesterol in the blood. Ezetimibe may be used alone or with other drugs (such as "statins" or fibrates). Brand Names: Zetia ..."

[horsie63 in reply to orangecity41]

I take Zetia as I could not tolerate statins (daily excruciating migraines). Been on it for several months now...over all chol is down to 233 from 262, tri down to 108 from 221, hdl up to 54 from 42, and ldl down to 157 from 207. I've been trying to be consistent with exercise but some days it's just hard. I do try and watch what I eat but sometimes that's hard too. I'm trying desperately to put on at least 5 more pounds but it's difficult to get enough calories from fruit/veggie I can and want to eat.

[drmind in reply to horsie63]

wow this is good to know. Is Zetia ok with CKD? I have an appt with my kidney doctor soon and I'll ask him, too. Thanks for sharing this information.

[horsie63 in reply to drmind]

It was my neph who prescribed it so I certainly hope so. This is what I found on Drugs.com. Most of the issues are with the liver as that's where its metabolized. So after ten days of taking it I had my liver enzymes checked, all were good. Muscle issues have been reported but I'm on a low dose and do just fine.

No dosage adjustment of ezetimibe is necessary in patients with renal impairment. However, when ezetimibe therapy is given in combination with simvastatin in patients with moderate to severe renal impairment (estimated glomerular filtration rate <60 mL/min/1.73 m2), doses of simvastatin exceeding 20 mg should be used with caution and close monitoring is recommended.

[drmind in reply to horsie63]

im excited about this and cant wait to talk to my nephrologist and primary. Only possible problem is that years ago. I did get some poor liver lab issues. So, we'll see. Thanks for taking the time and sharing your experiences

[horsie63 in reply to drmind]

my pleasure….I’ve always found your posts informative so it was nice to help.

[Sarah_402]

Hi drmind,Here a link from National Kidney Foundation.

kidney.org/news/kidneyCare/...

I have high cholesterol too, my doctor didn’t put me on anything. I need to talk to him. Maybe now that I eat more plant based my cholesterol levels could have improved, however one of my physicians said it can be genetics.

[drmind in reply to Sarah_402]

I read that article and now I'm hoping if I fix it, it will help with the CKD. We're all being proactive and have to be. Good luck with consulting with your doctor. Best to all...

[orangecity41 NKF Ambassador in reply to Sarah_402]

Thanks for the link to good information.

[Bet117 NKF Ambassador in reply to Sarah_402]

My nephrologist did mention that genetics can be a component; they also connect elevated cholesterol to diet, diabetes and heart issues which all can walk parallel with kidney issues.

Thanks.

[Bet117 NKF Ambassador]

Hi drmind,

I have had bouts with slightly elevated cholesterol due to my hashimotos hypo thyroid as well as my Membraneous Nephropathy. My PCP and nephrologist keep a watch on it. I know that they are attentive to cholesterol levels in kidney patients as well as BP, as they are connected. Due to a found statin allergy, my PCP and nephrologist worked together and put me on Plant Sterols, Omega 3 fish oil, garlique and flush free niacin. The niacin was a study that my nephrologist did during his residency and fellowship.

My cholesterol levels have been normal for several years now. I also am plant based and attentive to diet.

I can understand your concerns about the Lipitor as I had a violent reaction to it at the lowest dose. Although it and Creator are the most widely prescribed cholesterol meds, they have they are not for everyone.

I will see if I can find an article that I read about kidney disease and cholesterol; I will post it if I find it.

Warm thoughts.

Bet

[drmind in reply to Bet117]

Thanks Bet117 for the info offered. I'm just trying to he proactive and happy I have a nephrologist who is, too. My problem with Lipitor took place several years ago and I cant remember the dosage or just how severe the side effects were. But, I do want to work on the cholesterol. I also took Zetia and had poor results. Anyway, the mostly vegetarian diet that I'm on is a start as it did help improve all the cholesterol numbers but not enough. I'll also get back to more walking along with any meds that may be reciprocated down the line.

Take care. I'm always impressed with all the different medications you take when the usual ones dont work for you. I sense you have some very caring and involved doctors. Best to you.

[Bet117 NKF Ambassador in reply to drmind]

Thanks for your kind reply, drmind,

I am always happy to write to you.

Agreed that we are lucky to have great doctors who are pro- active and listen to us. It took me 3 tries to find my nephrologist, but he is amazing; I credit my PCP for him.

As far as the statins, I can understand your point to avoid if possible. I felt identically.

Against my wishes, my then endocrinologist insisted that I take Crestor 5 mg which is a base dose. Knowing about my kidney issues, my pharmacist red flagged it as that drug can promote protienuria; a symptom of my autoimmune kidney disorder.

Within 2 weeks, I already had back discomfort.

The endo insisted that I remain on a statin and changed it to Lipitor 10mg, also the base dose, which worsened the symptoms over several months; with the numbers not altering much on a completely plant based diet.

I looked both drugs up on Drugs. com and found that the pharmacist and I were right with the prescribing endo dismissing my pain.

My present PCP came on at the same time due to a retirement. She immediately diagnosed the allergy, removed the statin and we put together the alternatives.

She is now handling both my thyroid and overall cholesterol which has been normal for several years.

This is just me...

Remember that putting together a plan to keep the kidney disease and it's components stable is a process which will require tweaks from time to time. It's frustrating!

The diet changes, water and exercise and a new lifestyle are a great start to seeing the numbers drop. You will eventually be happier, I promise.

If you stabilize for a while, still good.

Stay positive and take good care of yourself. Things will come together..

Let me know how you are doing.

Bet

[Michael__S]

My HDL was found to be very low, close to zero. I should see next week if it rebounded after the nephrectomy.

I didn't have to the time to read it but yes there appear to be something between cholesterol and CKD but I don't know how well the theory (or proof?) is established. ncbi.nlm.nih.gov/pmc/articl....

[drmind in reply to Michael__S]

I agree about a connection but not sure what kind. So glad to get so many people responding and sharing their experiences. Its going to take all of us to put pressure on our doctors for them to take a closer look at cholesterol. It may be as important as BP or diabetes for causing CKD on some of us but we'll never know unless we all do our own little researches. Best to you all

And, for all of you in the USA. can I say

GO BEGALS on Sunday...its about time you won one.

[userotc]

Personally I believe that increased cholestrol is a sign of an underlying condition eg CKD, thyroid disease or CVD, rather than a cause. As an example for kidney disease, it is a characteristic of nephrotic syndrome healthline.com/health/nephr... along with other characteristics such as proteinuria. My mum's cholestrol has increased in recent years along with her proteinuria. Im not sure if reducing her cholestrol would also reduce her increasing proteinuria(?) but hopefully reducing her blood sugar (included in causes in the above link) might reduce it along with the cholestrol marker. Hence that is our current approach.

As indicated in Sarah's link re Physicians' Health Study, the balance of HDL and tot cholestrol (TC) may be more important than just TC. Mum's ratio of HDL and TC is not bad. But we also monitor her increasing LDL which is also linked in the Study (below) along with triglycerides which, as well as HDL, are more relevant in a 2nd study mentioned webmd.com/cholesterol-manag.... Mum's triglycerides have returned to normal in recent months.

[Skeptix]

Hi drmind,

Dunno about the connection and I'm in two minds about serum cholesterol and heart links.

My neff proposed putting me on a statin a year or so ago - my total cholesterol was firmly in the mid 6's (should be below 5). I was just embarking on a plant based, very low protein diet so suggested we wait and see.

Results since attached. There was a pretty immediate and significant alteration in a good direction between May 21 (old diet. Total Chol = 6.3) and August 21 (a few months into the new diet. Total Chol 5.2). Dunno why it went back up for August ( 5.5) but time will tell whether the lowering is sustained. They messed up my blood draw in Jan so I've to repeat in Feb. Will post then..

Cholesterol drop due to shift to low protein plant diet

[drmind in reply to Skeptix]

Thanks for sharing your info. I'm not sure what the connection is between cholesterol and kidney, but I feel as if there is definitely one. And, not sure if its causing CKD or a by-product of kidney disease. Whatever...I'm going to get my cholesterol numbers as close to normal as possible and see what happens. Keep us posted when you get the new labs. It looks as if you're diet is working. Best

[RitLa]

Hi drmind! I did have high cholesterol that blocked about 90% of my left renal artery. I had surgery to have a stent put in to open up the artery. Years later the stent developed a blood clot, which was also fixed with another stent. I then learned that this Renal Artery Stenosis led to Chronic Kidney Disease. My cardiologist did an ultrasound every 6 months to keep an eye on it. After my CKD dropped to Stage 3B, my primary care doctor referred me to a nephrologist who didn’t believe in ultrasounds. Consequently, the artery closed up, I guess from the cholesterol, and my left kidney died. So now I am dealing with trying to keep my right kidney from dying from CKD and high cholesterol. Needless to say, I found another kidney doctor, and I am working to keep my cholesterol under control, without the use of statins. Keeping that cholesterol controlled is so very important, who knew it could kill a kidney?

[drmind in reply to RitLa]

Oh, thank you for sharing your life's journey with cholesterol and your kidneys. So glad you changed doctors and are watching this condition closely again. You said you are doing this without medication. Are you doing this with diet alone? And maybe exercise as well. I'd love to know. Again, thanks for this important information. My best to you.

[RitLa in reply to drmind]

Thanks! I tried statins, but the side effects were horrible, so I stopped them. I have been watching my diet, cutting out all the bad stuff, basically following an anti-Inflammatory diet. I try to exercise. I’m 74 with back problems, but I do get in a little walking everyday. My cholesterol is down—still working on the triglycerides.

[drmind in reply to RitLa]

Wow. That sounds good. I'm in my 80o but always felt and acted as if I was in my 60o and 70o. I have back problems, too, but I use a walker and try to do a mile a day. I used to do 2 or 3 miles, but I stopped during covid and now I'm trying to get back. It's not easy. I'm also trying to watch my diet especially my sweet tooth. Even with my sweet tooth, my glucose is always within normal levels. Still, I cutting back. Thanks again for your information and keep us posted about those pesky triclycerides.

[KidneyCoach NKF Ambassador]

After 20 yrs on dialysis my triglycerides are 140, cholesterol 180. No medication for 6 years. Ten years ago my triglycerides were over 600, cholesterol was over 300. We changed how we ate and activity. Ive had several heart caths/angiograms which show 90% clear. Since #1 cause of death for dialysis patients is heart disease I find myself extremely fortunate. Blessings

[drmind in reply to KidneyCoach]

Wow, what a journey. Thanks for sharing this very important information. It reinforces my push to get busy and treat my cholesterol asap.

[Tony_Mimicted]

Hi, just to add about the things I know. I know that if you have proteinuria, your body (liver) tries to compensate for it by producing proteins such albumin and also lipoproteins which are responsible for the increased cholesterol

[wheezoids21 in reply to Tony_Mimicted]

that could be my problem right there. Im pumping out massive levels of protein. We tried upping my ace inhibitor to combat it, which helped slightly, but its still ridiculously high. Since I dont have blood pressure issues, but take meds for hyperkalemia, they cant up the dose any further. It doesnt seem to be an issue that can be solved

[chicablue]

yes, My cholesterol was 399 when I was only 39. That was 10 years before I almost died from meningococcal sepsis which resulted in kidney damage. After I recouped and came home my Neph put me on Lipitor and subsequently Zetia. i determined these types of drugs weaken your muscles and that was not ok with me. I had had my toes amputated and still needed to be able to walk and drive and the lipitor would cause cramps in my feet and legs. I discontinued those drugs to the dismay if my Dr. I dont even get the blood tests anymore for triglycerides and cholesterol, so I dont know what they are, but my GFR stayed stable for many years since, confounding my Dr. I have lived with the kidney damage now since 1995!i dont believe in those chol lowering drugs. They weaken muscles, and your heart is a muscle. Think about that. They are also blamed for causing dementia. Do you know your brain us made up of cholesterol? My opinion is too many drugs have been formulated just to make $$ for big pharma. After all, my parents never had a cholesterol test, and they both lived to mid 90's. My Dr was amazed, I was with him for 24 years before he retired. He thought my life expectancy would be 10 yrs max when he met me. So far |I have lived 27 years without the cholesterol drugs.

[drmind in reply to chicablue]

Thank you so much for this very useful information. I do not do well with the statins either. Furthermore, I believe and I've been told that its likely my cholesterol is a genetic condition as it's been high most of my life and I'm in my 80's. We'll see what happens with my vegetarian diet. Both my parents were also long-lived and never had labs for cholesterol. My cardiologist recommended vascepa which I believe is a fish oil supplement, but I'm not sure. I totally agr

[chicablue in reply to drmind]

I am a firm believer in supplements, but my dr did not. He warned me not to take any. But he didnt believe in vitamins either. I carefully researched every thing I took. years later I was still stable and asked him if I should do something different (he didnt know about my supplements) He said "Keep doing exactly what you're doing!" I have been taking fish oil, phosphatidyl choline to protect my liver, and vit K2 to protect heart and arteries. so far have been doing well. Am just now switching to less animal protein and more plants. Good luck!

[drmind in reply to chicablue]

My best to you. too. You know I truly believe that there is a formula that has yet to be developed that slows the CKD progression. But, since all of us have different labs and different health issues, it has to be a complicated one. Hope someone is working on it. Someday, we'll just plug in our data and get the specific formula for each of us. Right now. I'm seriously considering the vascepa once I talk it over wirh my kidney doctor.

Most doctors appear to shunt supplements and one reason may be because they're so poorly regulated.

Again, thanks for taking the time and sharing your experiences. And, good luck with starting your new diet. Keep in touch..

[Blackknight1989]

drmind I am sure you have found your answers by now but if not I’ll offer a short explanation that I have gathered from being housebound the last 2 years and the fact I actually enjoy reading medical research studies. I use me research of the studies around the SGLT2 Jardiance conducted over the last 4 years with participants who have all stages of CKD or none, T2D or none, HBP or none etc. the last EMPA study wrapped up early in March of the year. The benefits of Jardiance to people like me are significant. It does stop CKD progression and increases eGFR as much as 37%, reduces proteinuria up to 49%, and has over a 50% lowering effect on cholesterol and reduces the chance of all cause mortality 52% as well as reducing the chance of a significant CVD event more than 50%. So instead of viewing CKD as a kidney issue it is a multi-system issue. With CKD especially the stage 3b or lower we have increased chances of CVD, HBP, hyperlipidemia, osteoporosis, anemia, nerve damage, thyroid issues, Graves’ disease and diabetes. With diabetes if controlled we don’t have multi-system risk to the same degree as CKD, with hyperlipidemia we have CVD risk but not a list like CKD. So if you think that by fixing cholesterol it will help with CKD it will, if you think that following recommendations to improve eGFR aimed at preserving kidney function will help improve cholesterol it may. At least that’s my grasp of the situation but I’m not a medical professional so what do I really know?!?

[wheezoids21]

I have high cholesterol with kidney disease which only started once I reached stage 4 ckd. I wanted to try and treat it without medication. So I went on a plant based diet for 6 months and really watched my diet. At the end of 6 months my bad cholesterol had doubled. The doctor said its just how my body works and put me on a statin. I have read, however, that kidney disease affects your bodys ability to process cholesterol so that may also be the case.

[drmind in reply to wheezoids21]

thanks for sharing your experience with cholesterol. Ive had cholesterol problems for years and attemps with statins (Lipitor) several years ago caused muscle problems. Ive been told my cholesterol is likely genetic. I also tried a plant food diet for several months with with no improvement in cholesterol or my GFR. So, I switched to just eating a healthy diet that includes lots of salads and other vegetables plus small amounts of fish, eggs, and/or cheese. My GFR got back in the medium range (3b) and there's been a very slight improvement in my cholesterol levels. Really not sure why and really dont want to attrubute it to diet alone. Along with advice from my primary and nephrologist, I also started to take a low dose statin (pravastatin) which I'm tolerating well. We'll see in a few months if any positive changes take place.

I'm realizing that we're all different and may need different treatment programs. Given the presence of various medical problems, stage of our CKD, and especially our different lab results, we need to remember how individual we are.

My best to you