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Chronic kidney disease on hemodialysis is associated with decreased serum PCSK9 levels

H Abujrad1, J Mayne2, M Ruzicka3

  • 1Division of Endocrinology and Metabolism, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.

Atherosclerosis
|February 18, 2014
PubMed

Insights

Serum PCSK9 (proprotein convertase subtilisin/kexin type 9) is lower in hemodialysis patients, correlating with LDL-C. Statin use disrupts this PCSK9-LDL-C link, suggesting PCSK9 still influences cholesterol in these patients.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Biochemistry

Background:

  • Serum low-density lipoprotein-cholesterol (LDL-C) is typically correlated with serum PCSK9 (proprotein convertase subtilisin/kexin type 9) in the general population.
  • Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) exhibit lower total cholesterol (TC) and LDL-C levels compared to the general population.
  • The relationship between serum PCSK9 and lipid levels in CKD patients on hemodialysis (CKD-HD) has not been previously reported.

Purpose of the Study:

  • To quantify serum PCSK9 levels in CKD-HD patients.
  • To investigate the relationship between serum PCSK9 and lipid profiles (TC, LDL-C, HDL-C, TG) in CKD-HD patients.
  • To assess the impact of statin therapy on serum PCSK9 and its correlation with LDL-C in CKD-HD patients.

Main Methods:

  • Serum PCSK9 and lipid levels were measured using ELISA in 66 CKD-HD patients and compared to 178 non-CKD controls.
  • CKD-HD patients were stratified into two groups: those not on statin therapy (HD-NS) and those on statin therapy (HD-S).
  • No control subjects were receiving statin therapy.

Main Results:

  • Serum PCSK9, TC, LDL-C, and HDL-C levels were significantly lower in the overall CKD-HD group compared to controls.
  • In HD-NS patients, lower PCSK9, TC, and LDL-C levels were observed, with PCSK9 correlating positively with TC, LDL-C, and triglyceride (TG) levels.
  • In HD-S patients, serum PCSK9 levels were comparable to the non-CKD group, and no significant correlation was found between PCSK9 and LDL-C.

Conclusions:

  • This study provides the first quantitative analysis of serum PCSK9 in CKD-HD patients, revealing decreased levels in those not on statins.
  • Serum PCSK9 in HD-NS patients remains a significant determinant of LDL-C, indicating its regulatory role in cholesterol metabolism is preserved.
  • Statin therapy appears to disrupt the correlation between LDL-C and PCSK9 in CKD-HD patients, suggesting a potential interaction in lipid management.
Abstract

Keywords:
Chronic kidney diseaseHemodialysisLDL-CPCSK9Statin

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