Chronic kidney disease induced dysfunction of high density lipoprotein

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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Suguru Yamamoto1, Valentina Kon

  • 1Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Clinical and Experimental Nephrology
|September 11, 2013
PubMed

Insights

Cardiovascular disease risk in chronic kidney disease (CKD) patients on dialysis is high. Abnormalities in high-density lipoprotein (HDL) function, not just quantity, may explain this increased risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Traditional cardiovascular disease (CVD) risk factors inadequately explain the high CVD burden in chronic kidney disease (CKD) patients, especially those on dialysis.
  • Patients with end-stage kidney disease (ESKD) on dialysis exhibit limited cardiovascular benefits from standard lipid-lowering therapies, indicating a significant residual risk.

Purpose of the Study:

  • To investigate the role of high-density lipoprotein (HDL) quantity and functionality in the residual cardiovascular risk observed in patients with chronic kidney disease.
  • To explore how chronic kidney disease impacts the composition and functional capabilities of HDL particles.

Main Methods:

  • Analysis of HDL composition and functionality in patients with chronic kidney disease.
  • Assessment of cholesterol acceptor function and inflammatory effects associated with HDL in the CKD population.
  • Evaluation of the correlation between HDL abnormalities and residual cardiovascular risk.

Main Results:

  • Chronic kidney disease significantly alters HDL composition and impairs its functionality, including cholesterol efflux capacity and anti-inflammatory properties.
  • These HDL abnormalities in CKD patients do not consistently correlate with each other, suggesting distinct underlying mechanisms.
  • HDL quantity alone does not fully account for the heightened cardiovascular risk in this cohort.

Conclusions:

  • Aberrant HDL functionality, beyond mere quantity, is a critical contributor to the exaggerated cardiovascular risk in patients with chronic kidney disease on dialysis.
  • Distinct mechanistic pathways underlie the various functional impairments of HDL in CKD.
  • Targeting specific HDL functional defects offers a promising novel therapeutic strategy for mitigating cardiovascular risk in CKD patients.

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