Evaluation of serum lipid abnormalities in chronic nephritis

In glomerular disease, disorders of lipid metabolism are suspected as factors exacerbating glomerular dysfunction. Although many reports have been published regarding metabolic disorders of lipids in renal disease, including nephrotic syndrome and chronic renal failure, there have been few published reports describing metabolic disorders of lipids in chronic nephritis. Therefore, in patients with IgA nephritis, we evaluated correlations between serum lipid levels and renal function and proteinuria.

In 191 patients with IgA nephritis, we evaluated the correlations between serum lipid levels and renal function [creatinine clearance (CCr)] and proteinuria (UP). Serum lipids examined included total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoproteins, phospholipids (PL), lipoprotein(a) [Lp(a)], and malondialdehyde (MDA).

Significant correlations were observed between serum lipid levels and CCr, UP, and age. There were no abnormalities in the mean values of respective serum lipids examined. Although TC levels increased with age, HDL-C levels were not correlated with age. Hyperlipidemia was observed in 39.8% of subjects. Significant correlations were observed between levels of TC, TG, PL, LDL-C, apoB, apoC-II, and apoC-III and Ccr, UP, and age. Significant correlations were also observed between levels of MDA, apoB/apoA-I, apoE/apoC-III, and Ccr and age, as well as between apoE levels and UP and age. The levels of apoA-I and apoA-I/apoA-II ratio were significantly correlated with UP alone, whereas the apoC-II/apoC-III ratio was significantly correlated with Ccr alone. There were no significant correlations between levels of HDL-C, apoA-II, and Lp(a) and Ccr, UP, and age.

Age, proteinuria, and renal function were related with changes in serum lipid levels in IgA nephritis. There were correlations between proteinuria and levels of apoA, as well as between renal function and apoC levels.