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Plasma high-density lipoprotein concentrations in chronic-hemodialysis and renal-transplant patients
Insights
Patients undergoing chronic hemodialysis or renal transplants have lower high-density lipoprotein cholesterol. This elevates the risk of atherosclerosis and cardiovascular disease due to altered lipid profiles.
Area of Science:
- Cardiovascular Science
- Nephrology
- Lipid Metabolism
Background:
- Epidemiologic studies link low high-density lipoprotein (HDL) cholesterol to increased atherosclerosis risk.
- Patients with chronic kidney disease often exhibit accelerated atherosclerosis.
Purpose of the Study:
- To investigate HDL cholesterol levels in patients on chronic hemodialysis and renal transplants.
- To compare lipid profiles in renal patients with controls, assessing atherosclerosis risk factors.
Main Methods:
- Measured high-density lipoprotein (HDL) cholesterol concentrations in hemodialysis and renal transplant patients.
- Compared HDL and low-density lipoprotein (LDL) cholesterol ratios against control groups (random and matched).
Main Results:
- Renal patients showed significantly lower HDL cholesterol (P < 0.01).
- Patients had significantly higher LDL to HDL cholesterol ratios (P < 0.01) compared to controls.
- Dialysis and transplant groups exhibited elevated LDL/HDL ratios (3.7 +/- 2.1 and 5.4 +/- 2.3, respectively).
Conclusions:
- Altered lipid profiles, specifically lower HDL and higher LDL/HDL ratios, are present in renal patients.
- These lipid alterations may contribute to the increased cardiovascular morbidity and mortality observed in these patient groups.
Abstract:
Since epidemiologic studies show that the risk of clinically evident atherosclerosis correlates negatively with concentrations of high-density lipoprotein, we sought to determine whether patients on chronic hemodialysis or recipients of renal transplants had alterations in this lipoprotein similar to those described in other disorders associated with accelerated forms of atherosclerosis. High-density-lipoprotein cholesterol concentrations in both groups of renal patients were significantly lower than control values (P less than 0.01), and their ratios of low-density-lipoprotein to high-density-lipoprotein cholesterol were significantly higher (P less than 0.01) than those observed in both randomly selected controls and in controls matched for plasma lipid levels (control, 2.4 +/- 1.2, dialysis, 3.7 +/- 2.1, and transplant, 5.4 +/- 2.3 mg per 100 ml [mean +/- S.D.]) if, as experimental evidence suggests, high-density lipoprotein retards the development of atherosclerosis, and low-density lipoprotein has opposite effects, the higher ratio of low-density-lipoprotein to high-density-lipoprotein cholesterol found in chronic-dialysis and renal-transplant patients may be related to their premature morbidity and mortality from cardiovascular causes.