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High density and low density lipoproteins in chronic renal failure before and after renal transplantation
Insights
Chronic renal failure and transplantation alter lipoproteins. Apo A levels normalize with stable kidney grafts, while Apo B increases in long-term transplant recipients, indicating distinct lipid changes in kidney disease and transplant outcomes.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Hyperlipoproteinaemia is common in chronic renal failure and after kidney transplantation.
- Lipoprotein abnormalities, specifically hypertriglyceridaemia, persist despite dialysis or transplantation.
- Hypercholesterolaemia is observed primarily in kidney transplant recipients.
Purpose of the Study:
- To re-examine hyperlipoproteinaemia in chronic renal failure and transplantation.
- To analyze apoprotein (apo A and apo B) levels in high-density lipoprotein (HDL) and low-density lipoprotein (LDL).
Main Methods:
- Analysis of apoprotein A and B levels in lipoproteins.
- Sequential analysis of 15 renal transplant recipients over time.
- Correlation of apoprotein levels with graft function stability.
Main Results:
- Apo A levels are reduced in undialyzed and dialyzed uraemic patients, and in early transplant recipients (<1 year).
- Apo A levels normalize in stable, long-term renal transplant recipients (>1 year), correlating with graft function.
- Apo B levels are normal in uraemic and dialyzed patients but elevated in long-term transplant recipients.
Conclusions:
- Apo A normalization in renal transplant recipients is linked to stable graft function.
- Elevated Apo B in long-term transplant recipients suggests lipid changes independent of kidney function restoration.
- Lipoprotein apoprotein profiles offer insights into metabolic complications of renal disease and transplantation.
Abstract:
The hyperlipoproteinaemia accompanying chronic renal failure and renal transplantation has been re-examined in terms of the apoprotein (apo A and apo B) moieties of the high density (HDL) and low density (LDL) lipoproteins. Hypertriglyceridaemia is prevalent in chronic uraemia and is not corrected by haemodialysis or renal transplantation. Hypercholesterolaemia is characteristic only of renal allograft recipients. Apo A levels are reduced in undialyzed uraemic and remain low during haemodialysis, as well as in patients with renal allografts of less than six months duration. In renal transplant recipients of greater than one year duration, apo A levels are normalized. The normalization of apo A level is related to the stability of graft function, as determined by sequential analysis of 15 renal transplant recipients. Apo B levels are normal transplant recipients. Apo B levels are normal in uraemic and dialyzed patients, but are elevated in long term transplant recipients. Unlike apo A levels, this alteration does not appear to reflect the restoration of kidney function.