High-density lipoprotein in uremic patients: metabolism, impairment, and therapy

Khoueiry, Georges; Abdallah, Marie; Saiful, Faisal; Rafeh, Nidal Abi; Raza, Muhammad; Bhat, Tariq; El‐Sayegh, Suzanne; Kalantar-Zadeh, Kamyar; Lafferty, James

doi:10.1007/s11255-012-0366-y

Cited by 9 publications

(8 citation statements)

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“…Increased oxidative damage in patients on chronic haemodialysis treatment has been considered to contribute to their increased cardiovascular risk [47][48][49], which cannot be completely explained by traditional cardiovascular risk factors and may be ameliorated with antioxidant intervention. Despite evidence for harmful effects in the general population of high doses of some common supplements (β-carotene, vitamin E, vitamin A) [50,51], there is evidence, although limited, that chronically haemodialysed patients could benefit from the use of antioxidants to prevent cardiovascular complications [52,53].…”

Section: Discussionmentioning

confidence: 99%

Ankyrin is the major oxidised protein in erythrocyte membranes from end-stage renal disease patients on chronic haemodialysis and oxidation is decreased by dialysis and vitamin C supplementation

Ruskovska

Bennett

Brown

et al. 2014

Free Radical Research

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Chronically haemodialysed end-stage renal disease patients are at high risk of morbidity arising from complications of dialysis, the underlying pathology that has led to renal disease and the complex pathology of chronic kidney disease. Anaemia is commonplace and its origins are multifactorial, involving reduced renal erythropoietin production, accumulation of uremic toxins and an increase in erythrocyte fragility.Oxidative damage is a common risk factor in renal disease and its co-morbidities, and is known to cause erythrocyte fragility. Therefore we have investigated the hypothesis that specific erythrocyte membrane proteins are more oxidised in endstage renal disease patients and that vitamin C supplementation can ameliorate membrane protein oxidation.Eleven patients and fifteen control subjects were recruited to the study. Patients were supplemented with 2 x 500mg vitamin C per day for four weeks. Erythrocyte membrane proteins were prepared pre-and post-vitamin C supplementation for determination of protein oxidation. Total protein carbonyls were reduced by vitamin C supplementation but not by dialysis when investigated by enzyme linked immunosorbent assay. Using a western blot to detect oxidised proteins, one protein band, later identified as containing ankyrin, was found to be oxidised in patients but not controls and was reduced significantly by 60% in all patients after dialysis and by 20% after vitamin C treatment pre-dialysis. Ankyrin oxidation analysis may be useful in a stratified medicines approach as a possible marker to identify requirements for intervention in dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Ankyrin is the major oxidised protein in erythrocyte membranes from end-stage renal disease patients on chronic haemodialysis and oxidation is decreased by dialysis and vitamin C supplementation

Ruskovska

Bennett

Brown

et al. 2014

Free Radical Research

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“… 14 , 16 , 17 Regarding HDL dysfunction in patients with ESRD, several studies have shown that HDL alters antioxidant and antiinflammatory effects in a chronic uremic state, either by a reduction in its antioxidant enzymes or by an impairment of their activity. 15 , 18 , 19 In addition, vascular smooth muscle cell hypertrophy, proliferation, and calcification have been reported to play a pivotal role in uremic vasculopathy. 20 – 22 Thus, vascular calcification caused by alterations in the metabolism of calcium, phosphorous, and parathyroid hormone (PTH) has been proposed as a potential risk factor for PAOD.…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis Is Associated With Increased Peripheral Artery Occlusive Disease Risk Among Patients With End-Stage Renal Disease

et al. 2015

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To investigate the effect of different dialysis modalities on the incidence of peripheral artery occlusive disease (PAOD) among patients with end-stage renal disease (ESRD) in a large population-based cohort study.The cohort study included 26,927 ESRD patients who underwent hemodialysis (17,737 patients, hemodialysis [HD] cohort) or peritoneal dialysis (PD, 9190 patients, PD cohort), and 107,588 matched controls between 2000 and 2010. A Cox proportional hazards model was to evaluate the risk of PAOD in the ESRD underwent HD or PD.Based on a mean follow-up period of 2.92, 3.64, and 4.91 years in the PD, HD, and control cohorts, respectively, the incidences of PAOD were 18.1% and 8.10% higher in the HD and PD cohorts, respectively, compared with the control cohort (log-rank test P < 0.001). The patients who underwent HD or PD exhibited a higher risk of PAOD compared with the control cohort regardless of age, sex, and presence or absence of comorbidities. In addition, the incidence of PAOD in the PD cohort and the propensity score-matched HD cohort were 12.4 and 20.7 per 1000 person-years, respectively, with a hazard ratio of 1.92 (95% confidence interval = 1.62–2.28) in HD patients, compared with the PD cohort.This nationwide population-based cohort study suggested a significantly increased risk of PAOD among ESRD patients. Moreover, the PD patients have a lower risk of developing PAOD compared with the HD cohort, indicating the beneficial roles of PD in reducing PAOD risk in ESRD patients.

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Section: Therapy Options In Ckd/esrd For Apolipoprotein and Pcsk9mentioning

confidence: 99%

“…In patients with CKD/ESRD, the use of PPARα agonists is still controversial, and long-term safety and efficacy remain open to research [62]. By using niacin, besides having no additional benefit in patients with satisfactory control of LDL-C concentrations, tolerability was reduced [62]. ApoA-I mimetic is a new challenge for improving the lipid profile (in animal models), but clinical trials are still needed to confirm widespread use [62].…”

Section: Therapy Options In Ckd/esrd For Apolipoprotein and Pcsk9mentioning

confidence: 99%

“…By using niacin, besides having no additional benefit in patients with satisfactory control of LDL-C concentrations, tolerability was reduced [62]. ApoA-I mimetic is a new challenge for improving the lipid profile (in animal models), but clinical trials are still needed to confirm widespread use [62]. Although cholesteryl ester transfer protein (CETP) and cholesterol acyltransferase (ACAT) inhibitors have significantly improved HDL levels, results from major clinical trials have identified increased cardiovascular events [62].…”

Section: Therapy Options In Ckd/esrd For Apolipoprotein and Pcsk9mentioning

confidence: 99%

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Apolipoproteins A and B and PCSK9: Nontraditional Cardiovascular Risk Factors in Chronic Kidney Disease and in End-Stage Renal Disease

Vlad

Foia

Popescu

et al. 2019

Journal of Diabetes Research

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Purpose. Nontraditional cardiovascular risk factors as apolipoprotein A (ApoA), apolipoprotein B (ApoB), and the proprotein convertase subtilisin/kexin type 9 (PCSK9) increase the prevalence of cardiovascular mortality in chronic kidney disease (CKD) or in end-stage renal disease (ESRD) through quantitative alterations. This review is aimed at establishing the biomarker (ApoA, ApoB, and PCSK9) level variations in uremic patients, to identify the studies showing the association between these biomarkers and the development of cardiovascular events and to depict the therapeutic options to reduce cardiovascular risk in CKD and ESRD patients. Methods. We searched the electronic database of PubMed, Scopus, EBSCO, and Cochrane CENTRAL for studies evaluating apolipoproteins and PCSK9 in CKD and ESRD. Randomized controlled trials, observational studies (including case-control, prospective or retrospective cohort), and reviews/meta-analysis were included if reference was made to those keys and cardiovascular outcomes in CKD/ESRD. Results. 18 studies met inclusion criteria. Serum ApoA-I has been significantly associated with the development of new cardiovascular event and with cardiovascular mortality in ESRD patients. ApoA-IV level was independently associated with maximum carotid intima-media thickness (cIMT) and was a predictor for sudden cardiac death. The ApoB/ApoA-I ratio represents a strong predictor for coronary artery calcifications, cardiovascular mortality, and myocardial infarction in CKD/ESRD. Plasma levels of PCSK9 were not associated with cardiovascular events in CKD patients. Conclusions. Although the “dyslipidemic status” in CKD/ESRD is not clearly depicted, due to different research findings, ApoA-I, ApoA-IV, and ApoB/ApoA-I ratio could be predictors of cardiovascular risk. Serum PCSK9 levels were not associated with the cardiovascular events in patients with CKD/ESRD. Probably in the future, the treatment of dyslipidemia in CKD/ESRD will be aimed at discovering new effective therapies on the action of these biomarkers.

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High-density lipoprotein in uremic patients: metabolism, impairment, and therapy

Cited by 9 publications

References 94 publications

Ankyrin is the major oxidised protein in erythrocyte membranes from end-stage renal disease patients on chronic haemodialysis and oxidation is decreased by dialysis and vitamin C supplementation

Ankyrin is the major oxidised protein in erythrocyte membranes from end-stage renal disease patients on chronic haemodialysis and oxidation is decreased by dialysis and vitamin C supplementation

Hemodialysis Is Associated With Increased Peripheral Artery Occlusive Disease Risk Among Patients With End-Stage Renal Disease

Apolipoproteins A and B and PCSK9: Nontraditional Cardiovascular Risk Factors in Chronic Kidney Disease and in End-Stage Renal Disease

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