High-density lipoprotein in uremic patients: metabolism, impairment, and therapy

Area of Science:

• Nephrology
• Cardiology
• Biochemistry

Background:

• Chronic kidney disease (CKD) is linked to increased cardiovascular disease (CVD) risk.
• Systemic oxidative stress and inflammation are hallmarks of CKD.
• High-density lipoprotein (HDL) function is impaired in CKD patients.

Purpose of the Study:

• To review the current understanding of HDL dysfunction in CKD.
• To explore the mechanisms by which HDL becomes dysfunctional in CKD.
• To discuss potential therapeutic strategies for HDL impairment in CKD.

Main Methods:

• Literature review of studies on HDL, oxidative stress, inflammation, and CKD.
• Analysis of the role of antioxidant enzymes and inflammatory pathways.
• Synthesis of information on the link between HDL dysfunction and atherosclerosis in CKD.

Main Results:

• HDL exhibits reduced antioxidant and anti-inflammatory capacity in CKD.
• Oxidative stress transforms HDL into a pro-oxidant and pro-inflammatory agent.
• Key CKD features like oxidative stress, inflammation, and lipid disorders facilitate atherosclerosis via HDL dysfunction.

Conclusions:

• HDL dysfunction is a significant contributor to accelerated atherosclerosis and cardiovascular mortality in CKD.
• Targeting oxidative stress and inflammation may restore HDL function.
• Further research into therapies for HDL impairment is warranted for CKD patients.