Final answer:
Decreased serum cholesterol in hemodialysis patients is linked to increased mortality due to conditions like malnutrition and haemodilution, influencing the balance between LDLs and HDLs which affects heart disease risk.
Step-by-step explanation:
Increased mortality in maintenance hemodialysis patients has been associated with decreased serum cholesterol due to multiple factors. Hemodialysis, a necessary life-sustaining treatment for individuals with kidney failure, can lead to a decrease in serum cholesterol because of complications such as haemodilution, malnutrition, and the loss of proteins through various conditions. Research indicates that low-density lipoproteins (LDLs) are connected with a higher risk of cardiovascular disease, while high-density lipoproteins (HDLs) contribute to a reduced risk. In this context, having a low serum cholesterol level, particularly in the LDL fraction, could indicate an increased risk of heart disease in hemodialysis patients because it might reflect undernutrition or severe illness rather than a beneficial low cholesterol level.
Dietary modifications and physical activity are recommended to improve the LDL/HDL ratio, favoring the prevention of heart disease, yet for hemodialysis patients, the interpretation of cholesterol levels requires careful consideration of their overall health status and the underlying causes of the reduced cholesterol levels.