4. Discussion
Diabetic nephropathy, death, cardiovascular disease, PAD, amputation, diabetic, dyslipidemia, Atherosclerosis, diabetes
DIABETIC NEPHROPATHY, CARDIOVASCULAR DISEASE, DISEASE, DIABETES MELLITUS, PAD, DYSLIPIDEMIA, EVENTS, ATHEROSCLEROSIS, DIABETES
The present study evaluated hemodialysis patients with dyslipidemia and demonstrated that high-dose EPA/DHA treatment provided an added benefit when combined with conventional therapy for PAD. Furthermore, an improvement in PAD severity was correlated with a reduction in RLP-C level, and this relationship was independent of statin use. These findings are consistent with those of a previous study that reported that high-dose EPA treatment prevented the occurrence of cardiovascular events [Notably, treatment with high-dose EPA/DHA helped reduce PAD severity with or without appropriate statin use, with the baseline mean LDL cholesterol level (69.0 mg/dL) comparable to that reported in a previous study (75.0 mg/dL) [Interestingly, the correlation between the reduction in RLP-C and the improvement in ABI was independently associated with a history of dialysis, the presence of diabetes, and baseline EPA and DHA concentrations. This may suggest that in patients with higher RLP-C, PAD may improve regardless of the duration of time since the induction of dialysis, and that improvement in PAD may be observed regardless of the presence or absence of diabetes mellitus. The risk of cardiovascular disease in diabetic patients remains high even with the use of statin therapy to lower LDL cholesterol. Diabetic nephropathy is the most common cause of dialysis induction, and high blood glucose levels increase triglycerides as the liver is more likely to produce triglycerides from excess sugar and insulin [RLP-C (produced by lipolysis from very-low-density lipoproteins and chylomicrons) is thought to contribute to this residual risk, although the factors mediating such a risk are not completely understood [A previous systematic review found that omega-3 fatty acids improved vascular access outcomes [Notably, a large cohort study showed that omega-3 fatty acids and statin reduced the risk of all-cause death, composite outcomes of endovascular treatment, and amputation in a dose-dependent manner in hemodialysis patients with dyslipidemia [In alignment with the current European Society of Cardiology and European Atherosclerosis Society guidelines [Clinical indicators for disease severity, such as low ABI scores, are associated with reduced health-related quality of life; however, patients with the same ABI can have widely varying symptoms, functioning, and health-related quality of life [