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HDL-inflammatory index correlates with poor outcome in hemodialysis patients

K Kalantar-Zadeh1, J D Kopple, N Kamranpour

  • 1Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA. kamkal@ucla.edu

Kidney International
|August 31, 2007
PubMed

Insights

High-density lipoprotein (HDL) can be inflammatory in chronic kidney disease (CKD) patients undergoing hemodialysis, especially with higher body fat. This inflammatory HDL is linked to increased mortality risk and poorer quality of life.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Oxidative stress and cardiovascular disease are significant risks for patients with chronic kidney disease (CKD) on maintenance hemodialysis.
  • High-density lipoprotein (HDL) function may be altered in CKD patients, potentially influencing inflammation and outcomes.

Purpose of the Study:

  • To investigate the proinflammatory potential of HDL in patients with CKD undergoing maintenance hemodialysis.
  • To explore the relationship between HDL's inflammatory index, body fat percentage, quality of life, and mortality risk.

Main Methods:

  • Assessed low-density lipoprotein (LDL) fluorescence as an index of proinflammatory potential.
  • Measured total body fat using near-infrared interactance and quality of life using SF36 questionnaires in 189 CKD patients.
  • Followed patients for 30 months, analyzing HDL's inflammatory index in relation to body fat and mortality.

Main Results:

  • HDL exhibited anti-inflammatory properties overall, but with significant variability.
  • 17% of patients displayed a proinflammatory HDL index, correlating with lower SF36 scores.
  • HDL's proinflammatory potential increased progressively with higher body fat percentages (up to 40%).
  • A higher proinflammatory HDL index was associated with an increased 30-month adjusted hazard ratio for death.

Conclusions:

  • Inflammatory HDL plays a significant role in the poor outcomes observed in patients with CKD on hemodialysis.
  • Targeting HDL's inflammatory properties may be a potential strategy to improve survival and quality of life in this patient population.

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