Lipid Profile Is Negatively Associated with Uremic Toxins in Patients with Kidney Failure—A Tri-National Cohort

Abstract

Patients with kidney failure (KF) have a high incidence of cardiovascular (CV) disease, partly driven by insufficient clearance of uremic toxins. Recent investigations have questioned the accepted effects of adverse lipid profile and CV risk in uremic patients. Therefore, we related a panel of uremic toxins previously associated with CV morbidity/mortality to a full lipid profile in a large, tri-national, cross-sectional cohort. Total, high-density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL), and remnant cholesterol, as well as triglyceride, levels were associated with five uremic toxins in a cohort of 611 adult KF patients with adjustment for clinically relevant covariates and other patient-level variables. Univariate analyses revealed negative correlations of total, non-HDL, and LDL cholesterol with all investigated uremic toxins. Multivariate linear regression analyses confirmed independent, negative associations of phenylacetylglutamine with total, non-HDL, and LDL cholesterol, while indole-3 acetic acid associated with non-HDL and LDL cholesterol. Furthermore, trimethylamine-N-Oxide was independently and negatively associated with non-HDL cholesterol. Sensitivity analyses largely confirmed findings in the entire cohort. In conclusion, significant inverse associations between lipid profile and distinct uremic toxins in KF highlight the complexity of the uremic milieu, suggesting that not all uremic toxin interactions with conventional CV risk markers may be pathogenic.

HDL-C and creatinine levels at 1 month are associated with patient 12-month survival rate after kidney transplantation

“…Uremia, a condition often present in those with decreased kidney function, can cause dyslipidemia, which also manifests through a decreased HDL-C cholesterol level, hypertriglyceridemia, and increased oxidation of LDL cholesterol [15]. Direct evidence has proven that lipid metabolism disorders can produce nephrotoxic substances, contributing to further deterioration of uremia [16]. Our study thus also underscores the role of lipid metabolism disorders as risk factors for the outcomes of renal transplantation.…”

Blood–Brain Barrier Biomarkers before and after Kidney Transplantation

“…Biomarker analyses from the circulation were conducted on plasma samples from 74 living-donor KT patients [ 71 , 72 ] recruited between September 2012 and March 2019 for the baseline, and followed up two years post-KT between October 2014 and May 2021.…”

Liquid Chromatography-Mass Spectrometry Analytical Methods for the Quantitation of p-Cresol Sulfate and Indoxyl Sulfate in Human Matrices: Biological Applications and Diagnostic Potentials

“…-Age (years): 68 [61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77] (median, range), 71 [65][66][67][68][69][70][71][72][73][74][75][76][77][78], and 67 [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]. p < 0.001.…”