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Causes of Low Cholesterol in People with Kidney Disease

Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician

To determine the causes of low cholesterol, it’s good to know what cholesterol is. It’s a fatty substance that is produced by your body. Cholesterol is also present in some of the foods you eat. Too much cholesterol can build up and sometimes lead to a narrowing of the arteries, also known as hardening of the arteries, that restricts blood flow.

When the blood vessels of your heart become restricted, coronary heart disease develops. If your heart doesn’t get the blood and oxygen it needs, you could experience chest pain or even a heart attack.

In the general population, high cholesterol puts people at risk for cardiovascular disease. But for people with chronic kidney disease (CKD) and those on dialysis, the relationship between cholesterol level and heart disease is not as certain. In the United States, approximately 500,000 people are undergoing dialysis, and nearly half of those patients will die of cardiovascular disease complications.

Yet some studies have shown that dialysis patients with higher cholesterol levels actually live a longer life than those with lower cholesterol levels. This is not to say that high cholesterol is good for CKD patients. Rather, the high cholesterol levels in some patients can suggest that they experience a lesser degree of two complications of kidney disease: malnutrition and inflammation.

Malnutrition and inflammation in patients with kidney disease

Malnutrition is common among patients with end stage renal disease (ESRD) and can affect up to 75 percent of dialysis patients.

It is believed that toxins not removed by dialysis can interfere with a patient’s sense of taste and smell. Without a normal sense of smell, food can lose its appeal, and dialysis patients become uninterested in eating. This leads to severe malnutrition and is one of the reasons why a patient’s cholesterol declines to a low level.

As an individual’s kidney function declines, he or she typically eats less and less food. Elderly patients in particular may develop cachexia, a disease that results in loss of weight and muscle mass.

If food has lost its appeal for you, talk to your renal dietitian about the types of food you should eat and what can be done to enhance food’s flavor, such as the addition of herbs and spices.

Cholesterol levels also tend to be lower if a patient is intentionally placed on a low-calorie diet or was prescribed a cholesterol-lowering medication.

Inflammation is another common complication of CKD, and some research has linked inflammation and low cholesterol levels. Although low cholesterol levels in people with kidney disease may be an indicator of other health conditions, most experts agree that, at this time, it is not entirely clear what the link is.

Malnutrition and inflammation in patients with CKD can complicate blood cholesterol test results. Your healthcare team will want to thoroughly examine all of the possible causes of your low cholesterol reading.


For most people, a low cholesterol reading indicates less risk of cardiovascular disease. For a patient with kidney disease, the cause of a low cholesterol reading can be an indicator of underlying kidney disease complications, such as malnutrition and inflammation. Your doctor will examine all possible causes of your low cholesterol level so the right treatment is prescribed, and you can live a better quality of life with kidney disease.

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