Lipoprotein Metabolism Abnormalities in Patients with Chronic Renal Insufficiency

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Lipoprotein Metabolism Abnormalities in Patients with Chronic Renal Insufficiency

Patients with chronic renal insufficiency (CRI) on hemodialysis develop lipoprotein abnormalities that may contribute to increased risk for atherosclerosis. The objective of this study was to assess the atherogenic risk of chronic renal insufficiency patients and dialysis treated patients (DTP) by measuring total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and calculating the risk factor ratio: TC/HDL-C and LDL-C/HDL-C. The examined group consisted of 18 chronic renal insufficiency patients and 60 patients on hemodialysis. The results were compared to a control group of 85 voluntary blood donors. Serum lipid parameters were examined by standard methods. All lipid parameters in hemodialysis patients were statistically different as compared to the control group (p<0.05) while chronic renal insufficiency patients showed significant difference only in triglycerides and HDL-cholesterol. Hypertriglyceridemia was present in both examined groups of patients and HDL-cholesterol was lower within both groups. All calculated atherogenic ratios were higher for patients than the control group. Lipid parameters were compared between chronic renal insufficiency and hemodialysis patients, but statistically significant difference was obtained only for HDL-cholesterol (p<0.05). The increased values of triglycerides and lower HDL-cholesterol in chronic renal insufficiency patients contribute to high incidence of cardiovascular disease. Chronic renal insufficiency patients have impaired reverse cholesterol transport from peripheral cells to lipoproteins, decreased levels of HDL-cholesterol, hypertriglyceridemia prevalence of small, dense LDL and increased levels of potentially atherogenic remnant particles.

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  • Ma KW Green EL Raij L. Cardiovascular risk factors in chronic renal failure and hemodialysis populations. Am J Kidney Dis 1992; 19: 505-13.

  • Jungers P Massy ZA Nguzen Khoa T Fumeron C Labrunie M Lacour B. Incidence and risk factors of atherosclerotic cardiovascular accidents in predialysis chronic failure patients: a prospective study. Nephrol Dial Transplant 1997; 12: 2597-602.

  • Herzog CA. Acute myocardial infarction in patients with end-stage renal disease. Kidney Int 1999; 56 (71 Suppl): 130S-133S.

  • Mittman N Avram MM. Dyslipidemia in renal disease. Seminars in Nephrology 1996; 16: 202-13.

  • Koniger MK Quaschning T Wanner C Schollmeyer P Kramer-Guth A. Abnormalities in lipoprotein metabolism in hemodialysis patients. Kidney Int 1999; 56 (71 Suppl): 248S-250S.

  • Senti M Romero R Pedro-Botet J Pelegri A Nogues X Rubies-Prat J. Lipoprotein abnormalities in hyperlipidemic and normolipidemic men on hemodialysis with chronic renal failure. Kidney Int 1992; 41: 1394-9.

  • O'Neal D Lee P Murphy B Best J. Low density lipoprotein particle size distribution in end-stage renal disease treated with hemodialysis or peritoneal dialysis. Am J Kidney Dis 1996; 27: 84-91.

  • Rajman I Harper L McPake D Kendall MJ Wheeler D. Low-density lipoprotein subfraction profiles in chronic renal failure. Nephrol Dial Transplant 1998; 13: 2281-7.

  • Arnadottir M. Pathogenesis of dyslipoproteinemia in renal insufficiency: the role of lipoprotein lipase and hepatic lipase. Scand J Clin Invest 1997; 57: 1-11.

  • Chan MK Persaud J Varghese Z Moorhead JF. Pathogenic role of post-heparin lipases in lipid abnormalities in hemodialysis patients. Kidney Int 1984; 25: 812-8.

  • Murase T Cattran DC Rubinstein B Steiner G. Inhibition of lipoprotein lipase by uremic plasma a possible cause of hypertriglyceridemia. Metabolism 1975; 24: 1279-186.

  • Persson E Nordstrom J Nilsson-Ehle P. Plasma kinetics of lipoprotein lipase and hepatic lipase activities induced by heparin and a low molecular weight heparin fragment. Scand J Clin Invest 1987; 47: 151-5.

  • Wakabayshi Y Okubo M Shimada H Sato N Koide A Marumo F. Decreased VLDL apolipoprotein CII/ apolipoprotein CIII ratio may be seen in both normotriglyceridemic and hypertriglyceridemic patients on chronic hemodialysis treatment. Metabolism 1987; 36: 815-20.

  • Horkko S Savolainen MJ Kervinen K Kesaniemi YA. Carbamylation-induced alterations in low-density lipoprotein metabolism. Kidney Int 1992; 41: 1175-81.

  • Bucal R Makita Z Vega G Grundy S Koschinsky T Cerami A. Modification of LDL by advanced glycosylation endproducts contributes to the dyslipidemia of diabetes and renal insufficiency. Proc Natl Acad Sci USA 1994; 91: 9441-5.

  • Hokko S Huttunen K Korhonen T Kesaniemi YA. Decreased clearance of low density lipoprotein in patients with chronic renal failure. Kidney Int 1994; 45: 561-70.

  • Shoji T Nishizava Y Nishitani H Yamakawa M Morii H. Impaired metabolism of high density lipoprotein in uremic patients. Kidney Int 1992; 41: 1653-61.

  • Vaziri ND Deng G Liang K. Hepatic HDL receptor SR'B1 and apo AI expression in chronic renal failure. Nephrol Dial Transplant 1999; 14: 1462-6.

  • Massy ZA Nguyen Khoa T Lacour B Descamps-Latscha B Man NK Jungers P. Dyslipidemia and the progression of renal disease in chronic renal failure patients. Nephrol Dial Transplant 1999; 14: 2392-7.

  • Attman PO Alaupovic P Samuelsson P. Lipoprotein abnormalities as a risk factor for progressive nondiabetic renal disease. Kidney Int 1999; 56 (71 Suppl): 14S-17S.

  • Attman PO Samuelsson P Alaupovic P. Lipoprotein metabolism and renal failure. Am J Kidney Dis 1993; 21: 373-92.

  • Moorhead JF El-Nahas M Chan MK Varghese Z. Lipid nephrotoxicity in chronic progressive glomerular and tubulo-interstitial disease. Lancet 1982; 11: 1309-11.

  • Keane WF. Lipids and kidney. Kidney Int 1994; 46: 910-20.

  • Đerić M Čabarkapa V. Cardiovascular biomarkers in chronic kidney diseases. Journal of Medical Biochemistry 2010; 29: 298-303.

  • Sperschneider H Deppisch R Beck W Wolf H Stein G. Impact of membrane choice and blood flow pattern on coagulation and heparin requirement - potential consequences on lipid concentrations. Nephrol Dial Transplant 1997; 12: 3638-46.

  • Schmitt Y Schaeider H. Low-molecular-weight heparin (LMWH)): influence on blood lipids in patients on chronic hemodialysis. Nephrol Dial Transplant 1993; 8: 438-42.

  • Lacour B Roullet JB Beyne P. Comparison of several atherogenicity indices by analysis of serum lipoprotein composition in patients with chronic renal failure with or without hemodialysis and in renal transplant patients. J Clin Chem Biochem 1985; 23: 805-10.

  • Ot K Hirano T Sakai S Kawaguchi Y Hosoya T. Role of hepatic lipase in intermediate-density lipoprotein and small dense low-density lipoprotein formation in hemodialysis patients. Kidney Int 1999; 56 (71 Suppl): 227S-8S.

  • Galle J Heermeier K Wanner C. Atherogenic lipoproteins oxidative stress and cell death. Kidney Int 1999; 56 (71 Suppl): 62S-65S.

  • Ma KW Green EL Raij L. Cardiovascular risk factors in chronic renal failure and hemodialysis populations. Am J Kidney Dis 1992; 19: 505-13.

  • Gardner CD Fortmann SP Krauss RM. Association of small low density lipoprotein particles with the incidence of coronary artery disease in men and women. JAMA 1996; 276: 875-81.

  • Rajman I Kendall MJ Cramb R Holder RI Salih M Gammaage MD. Investigation of the low density lipoprotein subfractions profile as a coronary risk factor in normotriglyceridaemic men. Atherosclerosis 1996; 125: 231-242.

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