HDL-cholesterol levels and mortality in patients with ESRD

Vaziri, Nosratola D.

doi:10.1038/nrneph.2014.169

Cited by 7 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Intriguingly, however, higher efflux was independently associated with graft survival; thus, cholesterol efflux might represent a meaningful predictor of graft outcome. 17 Hence, our results extend previous observations that plasma HDL-C levels have little association with the risk of cardiovascular morbidity or mortality in ESRD 18 to the emerging area of HDL function studies. However, our findings are in apparent contrast to the prevailing view in the cardiovascular field that, at least in cohorts with normal or only mildly impaired kidney function, the cholesterol efflux capacity of HDL might be an even stronger predictor for CVD risk than the mere measurement of circulating levels of HDL-C or apoA-I.…”

supporting

confidence: 86%

HDL Cholesterol Efflux Does Not Predict Cardiovascular Risk in Hemodialysis Patients

Kopecky¹,

Ebtehaj

Genser

et al. 2016

JASN

View full text Add to dashboard Cite

The cardioprotective effect of HDL is thought to be largely determined by its cholesterol efflux capacity, which was shown to inversely correlate with atherosclerotic cardiovascular disease in populations with normal kidney function. Patients with ESRD suffer an exceptionally high cardiovascular risk not fully explained by traditional risk factors. Here, in a analysis in 1147 patients with type 2 diabetes mellitus on hemodialysis who participated in the German Diabetes Dialysis Study (4D Study), we investigated whether the HDL cholesterol efflux capacity is predictive for cardiovascular risk. Efflux capacity was quantified by incubating human macrophage foam cells with apoB-depleted serum. During a median follow-up of 4.1 years, 423 patients reached the combined primary end point (composite of cardiac death, nonfatal myocardial infarction, and stroke), 410 patients experienced cardiac events, and 561 patients died. Notably, in Cox regression analyses, we found no association of efflux capacity with the combined primary end point (hazard ratio [HR], 0.96; 95% confidence interval [95% CI], 0.88 to 1.06;=0.42), cardiac events (HR, 0.92; 95% CI, 0.83 to 1.02; =0.11), or all-cause mortality (HR, 0.96; 95% CI, 0.88 to 1.05;=0.39). In conclusion, HDL cholesterol efflux capacity is not a prognostic cardiovascular risk marker in this cohort of patients with diabetes on hemodialysis.

show abstract

supporting

confidence: 86%

HDL Cholesterol Efflux Does Not Predict Cardiovascular Risk in Hemodialysis Patients

Kopecky¹,

Ebtehaj

Genser

et al. 2016

JASN

View full text Add to dashboard Cite

show abstract

“…In the current study, we compared functional and structural characteristics of lipoproteins from RA patient to identify unique biomarkers. Increased plasma TG and reduced HDL-C levels are well characterized in patients with chronic or acute inflammatory disease, such as end stage renal disease [ 43 ] and hemorrhagic fever renal syndrome [ 44 ], respectively.…”

Section: Discussionmentioning

confidence: 99%

Patients with Rheumatoid Arthritis Show Altered Lipoprotein Profiles with Dysfunctional High-Density Lipoproteins that Can Exacerbate Inflammatory and Atherogenic Process

et al. 2016

View full text Add to dashboard Cite

ObjectiveIn order to identify putative biomarkers in lipoprotein, we compared lipid and lipoprotein properties between rheumatoid arthritis (RA) patients and control with similar age.MethodsWe analyzed four classes of lipoproteins (VLDL, LDL, HDL2, HDL3) from both male (n = 8, 69±4 year-old) and female (n = 25, 53±7 year-old) rheumatoid arthritis (RA) patients as well as controls with similar age (n = 13).ResultsAlthough RA group showed normal levels of total cholesterol (TC), low-density lipoprotein (LDL)-cholesterol, and glucose, however, the RA group showed significantly reduced high-density lipoprotein (HDL)-C level and ratio of HDL-C/TC. The RA group showed significantly elevated levels of blood triglyceride (TG), uric acid, and cholesteryl ester transfer protein (CETP) activity. The RA group also showed elevated levels of advanced glycated end (AGE) products in all lipoproteins and severe aggregation of apoA-I in HDL. As CETP activity and TG contents were 2-fold increased in HDL from RA group, paraoxonase activity was reduced upto 20%. Electron microscopy revealed that RA group showed much less HDL2 particle number than control. LDL from the RA group was severely oxidized and glycated with greater fragmentation of apo-B, especially in female group, it was more atherogenic via phagocytosis.ConclusionLipoproteins from the RA patients showed severely altered structure with impaired functionality, which is very similar to that observed in coronary heart patients. These dysfunctional properties in lipoproteins from the RA patients might be associated with high incidence of cardiovascular events in RA patients.

show abstract

“…This effect is associated with elevated HDL triglyceride and reduced HDL phospholipid contents, a diminished cholesterol ester-rich: cholesterol ester-poor HDL ratio 4,6,53,54 , and impaired HDL antioxidant, anti-inflammatory, and reverse cholesterol transport capacity 55,56 . Although HDL cholesterol is reduced in the majority of patients with ESRD, a proportion of patients show a marked elevation in HDL cholesterol that is paradoxically associated with increased cardiovascular and overall morbidity and mortality [57][58][59] . In contrast to healthy individuals, HDL in patients with ESRD is severely oxidized, exerts proinflammatory effects, and contains large amounts of albumin, lipoprotein-associated phospholipase A2, and serum amyloid A1.…”

Section: Ckd and Esrdmentioning

confidence: 99%

HDL abnormalities in nephrotic syndrome and chronic kidney disease

2015

Self Cite

View full text Add to dashboard Cite

| Normal HDL activity confers cardiovascular and overall protection by mediating reverse cholesterol transport and through its potent anti-inflammatory, antioxidant, and antithrombotic functions. Serum lipid profile, as well as various aspects of HDL metabolism, structure, and function can be profoundly altered in patients with nephrotic range proteinuria or chronic kidney disease (CKD). These abnormalities can, in turn, contribute to the progression of cardiovascular complications and various other comorbidities, such as foam cell formation, atherosclerosis, and/or glomerulosclerosis, in affected patients. The presence and severity of proteinuria and renal insufficiency, as well as dietary and drug regimens, pre-existing genetic disorders of lipid metabolism, and renal replacement therapies (including haemodialysis, peritoneal dialysis, and renal transplantation) determine the natural history of lipid disorders in patients with kidney disease. Despite the adverse effects associated with dysregulated reverse cholesterol transport and advances in our understanding of the underlying mechanisms, safe and effective therapeutic interventions are currently lacking. This Review provides an overview of HDL metabolism under normal conditions, and discusses the features, mechanisms, and consequences of HDL abnormalities in patients with nephrotic syndrome or advanced CKD.

show abstract

HDL-cholesterol levels and mortality in patients with ESRD

Cited by 7 publications

References 10 publications

HDL Cholesterol Efflux Does Not Predict Cardiovascular Risk in Hemodialysis Patients

HDL Cholesterol Efflux Does Not Predict Cardiovascular Risk in Hemodialysis Patients

Patients with Rheumatoid Arthritis Show Altered Lipoprotein Profiles with Dysfunctional High-Density Lipoproteins that Can Exacerbate Inflammatory and Atherogenic Process

HDL abnormalities in nephrotic syndrome and chronic kidney disease

Contact Info

Product

Resources

About