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Abnormalities in lipoprotein metabolism in hemodialysis patients

M Königer1, T Quaschning, C Wanner

  • 1Department of Medicine, University of Freiburg, Germany. koeniger@mm41.ukl.uni-freiburg.de

Kidney International. Supplement
|July 21, 1999
PubMed

Insights

Patients on hemodialysis with hypertriglyceridemia develop abnormal LDL particles. These modified LDLs accumulate, increasing atherosclerosis risk, especially in diabetic patients.

Area of Science:

  • Cardiovascular Research
  • Lipid Metabolism
  • Nephrology

Background:

  • Chronic hemodialysis patients face heightened atherosclerosis risk, often linked to dyslipidemia.
  • Elevated serum triglycerides are common, while cholesterol and LDL cholesterol remain normal.

Purpose of the Study:

  • To investigate how hypertriglyceridemia in hemodialysis patients, with and without diabetes, affects LDL metabolism.
  • To analyze the characteristics and cellular uptake of LDL particles in these patient groups.

Main Methods:

  • LDL was isolated from healthy controls, hypertriglyceridemic diabetics, and non-diabetic hemodialysis patients.
  • LDL subfractions were analyzed for lipid/protein content, glycation, and oxidation.
  • LDL uptake was studied using HepG2 cells (LDL receptors) and macrophages (scavenger receptors).

Main Results:

  • Hemodialysis patients showed elevated triglycerides with normal cholesterol; LDL particles were enriched with triglycerides.
  • A highly atherogenic small dense LDL subfraction accumulated, particularly in diabetic patients.
  • Modified LDL from hemodialysis patients had increased lipid peroxidation and impaired LDL receptor uptake, with enhanced scavenger receptor uptake.

Conclusions:

  • Impaired LDL receptor uptake of modified, triglyceride-rich, small dense LDL promotes in vivo accumulation and atherosclerosis.
  • Further clinical studies are needed to assess the benefits of lipid-lowering interventions for these atherogenic particles.
Abstract

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