Roles of hypoalbuminemia and lipoprotein lipase on hyperlipoproteinemia in continuous ambulatory peritoneal dialysis

Shoji, Tetsuo; Nishizawà, Yoshiki; Nishitani, Hiroshi; Yamakawa, Makoto; Morii, Hirotoshi

doi:10.1016/0026-0495(91)90120-l

Cited by 52 publications

(34 citation statements)

References 48 publications

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“…We 30) previously showed a high prevalence of 'mid-band' or 'broad beta pattern' on agarose gel electrophoresis in hemodiaysis and peritoneal dialysis patients. Other studies have found increased levels of intermediate-density lipoprotein (IDL) separated via ultracentrifugation in patients with CKD before dialysis 31) and on dialysis 5,6,9) .…”

Section: Discussionmentioning

confidence: 95%

Kidney Function, Cholesterol Absorption and Remnant Lipoprotein Accumulation in Patients with Diabetes Mellitus

Sonoda

Shoji

Kimoto³

et al. 2014

JAT

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Aim: Remnant lipoproteins are atherogenic and increased in patients with type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD) and other conditions. Thus far, information is limited regarding the synthesis and absorption of cholesterol in CKD patients and a possible link to the remnant levels. We examined possible alterations in serum markers of cholesterol synthesis and absorption and their potential associations with remnant lipoproteins in patients with CKD. Methods: The subjects included 146 consecutive patients with T2DM in various stages of CKD. We measured the levels of remnant lipoprotein cholesterol (RemL-C), lathosterol (a cholesterol synthesis marker) and campesterol (a cholesterol absorption marker). The urinary albumin to creatinine ratio (U-ACR) and estimated glomerular filtration rate (eGFR) were used to describe the degree of CKD. Results: The median (interquartile range) levels of RemL-C, lathosterol and campesterol were 14.5 (11.5-23.4) mg/dL, 2.1 (1.7-2.9) μg/mL and 2.3 (1.7-3.0) μg/mL, respectively. The RemL-C level was positively correlated with the U-ACR and inversely correlated with the eGFR. The RemL-C level was positively correlated with both the lathosterol and campesterol levels. The lathosterol level was not significantly correlated with the U-ACR, although it was positively correlated with the eGFR. In contrast, the campesterol level was positively correlated with the ACR and inversely with the eGFR. In the multiple regression analysis, both lathosterol and campesterol were positively associated with the RemL-C level, independent of the U-ACR, eGFR and other variables. Conclusions: The serum campesterol concentrations are higher in patients with a greater degree of albuminuria and a lower renal funtion. In this study, the markers of cholesterol absorption and synthesis were independent determinants of the RemL-C level. Increased intestinal cholesterol absorption may be an additional mechanism for remnant accumulation in T2DM patients with CKD.

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Section: Discussionmentioning

confidence: 95%

Kidney Function, Cholesterol Absorption and Remnant Lipoprotein Accumulation in Patients with Diabetes Mellitus

Sonoda

Shoji

Kimoto³

et al. 2014

JAT

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“…Although hypercholesterolemia is a major risk factor for CVD in the general population, it is not common in HD patients (3)(4)(5)(6). Rather, their lipoprotein profiles are characterized by reduced HDL-cholesterol (HDL-C) and elevated triglyceride (TG)-rich lipoprotein concentrations (3)(4)(5)(6).…”

mentioning

confidence: 99%

LCAT-Dependent Conversion of Preβ1-HDL into α-Migrating HDL is Severely Delayed in Hemodialysis Patients

Miida¹,

Miyazaki²,

Hanyu

et al. 2003

Journal of the American Society of Nephrology

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Abstract. Pre␤1-HDL is a minor HDL subfraction that acts as an efficient initial acceptor of cell-derived free cholesterol. During 37°C incubation, plasma pre␤1-HDL decreases over time due to its conversion to ␣-migrating HDL by lecithin: cholesterol acyltransferase (LCAT). This conversion may be delayed in hemodialysis patients who have decreased LCAT activity. To clarify whether LCAT-dependent conversion of pre␤1-HDL to ␣-migrating HDL is delayed in hemodialysis patients, pre␤1-HDL concentrations were determined in 45 hemodialysis patients and 45 gender-matched control subjects before and after 37°C incubation with and without the LCAT inhibitor. It was found that the baseline pre␤1-HDL concentration in hemodialysis patients was more than twice that in the controls (44.9 Ϯ 21.4 versus 19.8 Ϯ 6.7 mg/L apoAI; P Ͻ 0.001). After 2-h incubation, the LCAT-dependent decrease in pre␤1-HDL in hemodialysis patients was about one-third of that in the controls (30 Ϯ 27 versus 97 Ϯ 17% of baseline; P Ͻ 0.01). The LCAT-dependent rate of decrease in pre␤1-HDL levels (DR pre␤1 ) was the same for samples from hemodialysis patients exhibiting normal (Ն1.03 mmol/L) and low HDLcholesterol levels (32 Ϯ 32 versus 28 Ϯ 23% of baseline; NS). DR pre␤1 was positively correlated with LCAT activity (r ϭ 0.617; P Ͻ 0.001). In conclusion, the LCAT-dependent conversion of pre␤1-HDL to ␣-migrating HDL is severely delayed in hemodialysis patients. The impaired catabolism of pre␤1-HDL may accelerate atherosclerosis in hemodialysis patients.

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“…In a recent report from Italy 55) , the annual increase of the cross-sectional area of carotid atherosclerotic plaque was higher in CKD patients with CCr of 29-50 mL/min than in those with CCr of 20-29 decreased 42) . Patients with renal failure have an increased serum concentration of apoC-Ⅲ 43) , an inhibitor of LPL, as well as increased apoC-Ⅲ/C-Ⅱ ratio. Also, patients with renal failure show marked reduction of hepatic triglyceride lipase (HTGL) activity and HTGL protein mass in post-heparin plasma 42) .…”

Section: Dyslipidemia In Ckdmentioning

confidence: 99%

“…Decreased HTGL explains the accumulation of IDL 44) and normal LDL size 45) in renal failure. The most typical lipoprotein phenotype in renal failure is type Ⅳ with decreased high density lipoprotein cholesterol (HDL-C) 43) . In addition, a previous study using agarose gel electrophoresis 43) reported that as much as 23% of hemodialysis patients showed a broad β pattern or the presence of a mid-band between the β and pre-β peaks, indicating a high prevalence of remnant accumulation and type Ⅲ-like phenotype in this population.…”

Section: Dyslipidemia In Ckdmentioning

confidence: 99%

“…The most typical lipoprotein phenotype in renal failure is type Ⅳ with decreased high density lipoprotein cholesterol (HDL-C) 43) . In addition, a previous study using agarose gel electrophoresis 43) reported that as much as 23% of hemodialysis patients showed a broad β pattern or the presence of a mid-band between the β and pre-β peaks, indicating a high prevalence of remnant accumulation and type Ⅲ-like phenotype in this population. Possible mechanisms for decreased HDL-C are low activity of lecithin:cholesterol acyltransferase (LCAT), and enhanced lipid transfer between HDL and accumulated VLDL particles.…”

Section: Dyslipidemia In Ckdmentioning

confidence: 99%

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Chronic Kidney Disease, Dyslipidemia, and Atherosclerosis

Shoji

Abe

Matsuo³

et al. 2012

JAT

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Patients with chronic kidney disease (CKD) are at an increased risk not only for end-stage kidney disease (ESKD) but also for cardiovascular disease (CVD). In this review article, we summarize the current evidence of CKD as a high-risk condition for CVD based on reports from Japan and other countries to draw attention to the close clinical association between CKD and CVD. Several epidemiologic studies have shown that the presence of CKD and reduced renal function are independent predictors of CVD also in Japan. According to a post-hoc analysis of CASE-J, the power of CKD as a predictor of CVD is as strong as diabetes mellitus and a previous history of ischemic heart disease. CKD worsens classical risk factors including hypertension and dyslipidemia, and dyslipidemia is associated with increased thickness and stiffness of large arteries independent of major confounders. A post-hoc analysis of MEGA indicates that lipid-lowering therapy with statins reduces the risk of CVD, and that it appears to be more efficacious in patients with than without CKD. These reports from Japan and other countries suggest that CKD should be regarded as a high-risk condition comparable to diabetes mellitus, and that strict control of dyslipidemia would be beneficial in preventing CVD, at least early stages of CKD.

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Roles of hypoalbuminemia and lipoprotein lipase on hyperlipoproteinemia in continuous ambulatory peritoneal dialysis

Cited by 52 publications

References 48 publications

Kidney Function, Cholesterol Absorption and Remnant Lipoprotein Accumulation in Patients with Diabetes Mellitus

Kidney Function, Cholesterol Absorption and Remnant Lipoprotein Accumulation in Patients with Diabetes Mellitus

LCAT-Dependent Conversion of Preβ1-HDL into α-Migrating HDL is Severely Delayed in Hemodialysis Patients

Chronic Kidney Disease, Dyslipidemia, and Atherosclerosis

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