High-Density Lipoproteins and the Kidney

Strazzella, Arianna; Ossoli, Alice; Calabresi, Laura

doi:10.3390/cells10040764

Cited by 20 publications

(16 citation statements)

References 94 publications

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“…Smoking was reported in 9.5% of our study patients who had CKD progression, with a 2.8-fold increased risk for CKD progression; studies have reported that smoking is significantly associated with a higher risk of CKD and smoking is strongly associated with CKD progression [ 45 , 46 ]. Obesity and HDL cholesterol were not significantly associated with CKD progression in this study unlike findings from other studies where patients who had obesity and/or hyperlipidaemia had higher rates of CKD progression [ 47 , 48 ]. This difference could be due to the high prevalence of obesity/overweight in both progressor and non-progressor groups.…”

Section: Discussioncontrasting

confidence: 99%

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

Meremo

Paget²,

Duarte³

et al. 2023

PLoS ONE

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Background Chronic kidney disease (CKD) is a major public health issue worldwide and is an important contributor to the overall non-communicable disease burden. Chronic kidney disease is usually asymptomatic, and insidiously and silently progresses to advanced stages in resource limited settings. Methodology A prospective longitudinal study was carried out on black patients with CKD attending the kidney outpatient clinic at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa, between September 2019 to March 2022. Demographic and clinical data were extracted from the ongoing continuous clinic records, as well as measurements of vital signs and interviews at baseline and at follow up. Patients provided urine and blood samples for laboratory investigations as standard of care at study entry (0) and at 24 months, and were followed up prospectively for two (2) years. Data were descriptively and inferentially entered into REDcap and analysed using STATA version 17, and multivariable logistic regression analysis was used to identify predictors of CKD progression. Results A total of 312 patients were enrolled into the study, 297 (95.2%) patients completed the study, 10 (3.2%) patients were lost to follow and 5 (1.6%) patients died during the study period. The prevalence of CKD progression was 49.5%, while that of CKD remission was 33% and CKD regression was 17.5%. For patients with CKD progression the median age at baseline was 58 (46–67) years, the median eGFR was 37 (32–51) mL/min/1.73 m2, median urine protein creatinine ratio (uPCR) was 0.038 (0.016–0.82) g/mmol and the median haemoglobin (Hb) was 13.1 (11.7–14.4) g/dl; 95.2% had hypertension, 40.1% patients had diabetes mellitus and 39.5% had both hypertension and diabetes mellitus. Almost half (48.3%) of patients with CKD progression had severely increased proteinuria and 45.6% had anaemia. Variables associated with higher odds for CKD progression after multivariable logistic regression analysis were severely increased proteinuria (OR 32.3, 95% CI 2.8–368.6, P = 0.005), moderately increased proteinuria (OR 23.3, 95% CI 2.6–230.1, P = 0.007), hypocalcaemia (OR 3.8, 95% CI 1.0–14.8, P = 0.047), hyponatraemia (OR 4.5, 95% CI 0.8–23.6, P = 0.042), anaemia (OR 2.1, 95% CI 1.0–4.3, P = 0.048), diabetes mellitus (OR 1.8, 95% CI 0.9–3.6, P = 0.047), elevated HbA1c (OR 1.8, 95% CI 1.2–2.8, P = 0.007) and current smoking (OR 2.8, 95% CI 0.9–8.6, P = 0.049). Conclusion Our study identified a higher prevalence of CKD progression in a prospective longitudinal study of black patients with CKD compared with literature reports. CKD Progression was associated with proteinuria, diabetes mellitus, elevated HbA1c, anaemia, hypocalcaemia, hyponatraemia and current smoking in a cohort of black patients with CKD who had controlled hypertension and diabetes mellitus at baseline.

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Section: Discussioncontrasting

confidence: 99%

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

Meremo

Paget²,

Duarte³

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Smoking was reported in 9.5 % of our study patients who had CKD progression, with a 2.8-fold increased risk for CKD progression; studies have reported that smoking is significantly associated with a higher risk of CKD and smoking is strongly associated with CKD progression (42, 43). Obesity and HDL cholesterol were not significantly associated with CKD progression in this study unlike findings from other studies where patients who had obesity and/or hyperlipidaemia had higher rates of CKD progression (44, 45). This difference could be due to the high prevalence of obesity/overweight in both progressor and non-progressor groups.…”

Section: Discussioncontrasting

confidence: 99%

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

Meremo

Paget

Duarte

et al. 2022

Preprint

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Background: Chronic kidney disease (CKD) is a major public health issue worldwide and is an important contributor to the overall non-communicable disease burden. Chronic kidney disease is usually asymptomatic, and insidiously and silently progresses to advanced stages in resource limited settings. Methodology: A prospective longitudinal study was carried out on black patients with CKD attending the kidney outpatient clinic at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa, between September 2019 to March 2022. Demographic and clinical data were extracted from the ongoing continuous clinic records, as well as measurements of vital signs and interviews at baseline and at follow up. Patients provided urine and blood samples for laboratory investigations as standard of care at study entry (0) and at 24 months, and were followed up prospectively for two (2) years. Data were descriptively and inferentially entered into REDcap and analysed using STATA version 17, and multivariable logistic regression analysis was used to identify predictors of CKD progression. Results: A total of 312 patients were enrolled into the study, 297 (95.2%) patients completed the study, 10 (3.2%) patients were lost to follow and 5 (1.6%) patients died during the study period. The prevalence of CKD progression was 49.5%, while that of CKD remission was 33% and CKD regression was 17.5%. For patients with CKD progression the median age at baseline was 58 (46 - 67) years, the median eGFR was 37 (32 -51) mL/min/1.73 m2, median urine protein creatinine ratio (uPCR) was 0.038 (0.016 -0.82) g/mmol and the median haemoglobin (Hb) was 13.1 (11.7 – 14.4) g/dl; 95.2% had hypertension, 40.1% patients had diabetes mellitus and 39.5% had both hypertension and diabetes mellitus. Almost half (48.3%) of patients with CKD progression had severely increased proteinuria and 45.6% had anaemia. Variables associated with higher odds for CKD progression after multivariable logistic regression analysis were severely increased proteinuria (OR 32.3, 95 % CI 2.8 - 368.6, P = 0.005), moderately increased proteinuria (OR 23.3, 95% CI 2.6 - 230.1, P= 0.007), hypocalcaemia (OR 3.8, 95 % CI 1.0 - 14.8, P = 0.047), hyponatraemia (OR 4.5, 95% CI 0.8 - 23.6, P= 0.042), anaemia (OR 2.1, 95% CI 1.0 - 4.3, P= 0.048), diabetes mellitus (OR 1.8, 95 % CI 0.9 - 3.6, P = 0.047), elevated HbA1c (OR 1.8, 95 % CI 1.2 - 2.8, P = 0.007) and current smoking (OR 2.8, 95 % CI 0.9 - 8.6, P = 0.049). Conclusion: Our study identified a higher prevalence of progression of CKD in a prospective longitudinal study of black patients with CKD. Progression of CKD was associated with proteinuria, diabetes mellitus, elevated HbA1c, anaemia, hypocalcaemia, hyponatraemia and current smoking. This is a call for nephrologists and clinicians to be vigilant in identifying CKD patients at risk of CKD progression at early stages as this would allow risk stratification to improve kidney disease outcomes.

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“…In our study, renal defficiency was defined as an eGFR < 90 mL/(min·1.73 m 2 ), as renal damage and related dyslipidemia have already started in early stages of chronic kidney disease [ 22 ]. Chronic kidney disease is known to be an independent risk factor for cardiovascular disease, so it is reasonable to assume that with renal insufficiency in the picture, the size shifting of HDL particles, which reflects only an imbalance in HDL metabolism, is no longer a strong predictor of the severity of coronary heart disease [ 23 , 24 ]. In coronary heart patients with renal insufficiency, the protective effects of larger HDL particles may be weakened; thus, lipid-targeting therapy may not be as essential in these patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of renal function on high-density lipoprotein particles in patients with coronary heart disease

Jiang

Xue

Zeng

et al. 2021

BMC Cardiovasc Disord

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Background Although renal insufficiency and dyslipidemia are known to be closely associated, the effect of kidney function on the size and clinical value of high-density lipoprotein (HDL) particles remains largely unknown, especially in patients with coronary heart disease. Methods A total of 419 coronary heart disease patients and 105 non-coronary heart disease patients were included. HDL particle size, represented by HDL-C/apoA-I, was compared between groups stratified by estimated glomerular filtration rate (eGFR) and Gensini scores using standard Student’s t test and one-way ANOVA. Pearson’s correlation test was performed to analyze the association between eGFR and HDL-C/apoA-I in patients with coronary heart disease. The relationship between HDL particle size and the occurrence of coronary heart disease was explored using Univariate logistic regression analysis. Results In patients with coronary heart disease, between-group analysis revealed that HDL-C/apoA-I increased as eGFR declined, and significance appeared as eGFR declined to under 60 ml/min·1.73 m2 (P < 0.001), and Pearson's correlation test also confirmed an inverse correlation between eGFR and HDL-C/apoA-I levels in coronary heart disease patients. When stratified by Gensini scores, in coronary heart disease patients with eGFR ≥ 90 mL/(min·1.73 m2), those with higher Gensini scores had smaller HDL-C/apoA-I. However, with or without kidney insufficiency, smaller HDL-C/apoA-I was associated with a higher occurrence of coronary heart disease (P < 0.05). Conclusion With the presence of renal insufficiency, HDL-C/apoA1 was higher in patients with coronary heart disease. Lower HDL-C/apoA1 was still associated with a higher occurrence of coronary heart disease, but the original association between lower HDL-C/apoA1 and more severe coronary artery stenosis was lost in patients with renal insufficiency.

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High-Density Lipoproteins and the Kidney

Cited by 20 publications

References 94 publications

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa

Effect of renal function on high-density lipoprotein particles in patients with coronary heart disease

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