Low-density lipoprotein subfraction profiles in chronic renal failure

Abstract

The presence of small LDL particles appears to be an early and unexplained feature of the uraemic dyslipidaemia. This abnormality persists after renal transplantation and may represent an important atherogenic risk factor.

Role of dyslipidemia in impairment of energy metabolism, oxidative stress, inflammation and cardiovascular disease in chronic kidney disease

“…This is frequently accompanied by reduced plasma ApoA1 and high-density lipoprotein (HDL) cholesterol concentrations, and low or normal serum total cholesterol and low-density lipoprotein (LDL) cholesterol concentrations [2][3][4]. LDL in these patients consists of highly atherogenic small dense particles which contain abnormal levels of residual triglycerides [4][5][6]. In addition serum level of lipoprotein(a) [Lp(a)], particularly its low molecular forms is increased and contributes to cardiovascular disease in this population [7].…”

Lipoprotein Metabolism Abnormalities in Patients with Chronic Renal Insufficiency

“…Although elevated LDL-C is a classical atherogenic risk factor for cardiovascular disease, new evidence suggests that even normal LDL-C can be a very atherogenic particle (8). Independently of the etiology, hypertriglyceridemia leads to prominent compositional and configurational changes of LDLparticles.…”

“…Recent epidemio logical studies suggest, however, that a predominance of smaller and dense LDL (small, dense LDL) particles is highly atherogenic, and it may be a new risk factor for coronary heart disease. Previous results demon strate that dyslipidemia in dialysis-treated patients includes a shift in size distribution of LDL particles toward the potentially atherogenic small LDL particles (8). Small, dense LDL is thought to be more athero genic due to characteristics which include a lower affinity to the LDL receptor, an increased susceptibility to oxidation and an enhanced ability to penetrate to vascular intima and bind to intimal proteoglycans.…”

Cardiovascular Biomarkers in Chronic Kidney Disease

“…It is characterized by accu mulation of triglyceride-rich particles and decreased HDL-cholesterol concentrations, due to impaired triglyceride removal and/or increased triglyceride synthesis rate or VLDL apoB-100 overproduction (46). Cholesterol concentrations are typically similar to or lower than those in the general population (31,43), but this pattern often conceals a highly abnormal lipid subfraction profile with a predominance of athero genic small, dense LDL (sd LDL) and HDL particles (47). Furthermore, elevated serum Lp(a) concen trations have also been reported (48).…”