HDL and chronic kidney disease

Chiara Pavanello1, Alice Ossoli1

  • 1Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.

Insights

Low high-density lipoprotein cholesterol (HDL-C) is linked to chronic kidney disease (CKD) progression. HDL dysfunction in CKD patients may damage kidneys, suggesting HDL targeting as a potential therapeutic strategy.

Area of Science:

  • Lipid metabolism
  • Nephrology
  • Cardiovascular research

Background:

  • Low high-density lipoprotein cholesterol (HDL-C) is a hallmark of dyslipidemia in chronic kidney disease (CKD).
  • In CKD, HDL particles undergo structural and functional changes, losing atheroprotective properties and potentially becoming detrimental.
  • Reduced HDL-C levels are uniquely associated with CKD progression.

Purpose of the Study:

  • To review alterations in HDL structure and function in CKD.
  • To explore the link between genetic HDL metabolism defects and kidney dysfunction.
  • To discuss targeting the HDL system as a strategy to slow CKD progression.

Main Methods:

  • Literature review of studies on HDL metabolism in CKD.
  • Analysis of genetic mutations affecting HDL components (e.g., APOA1, APOE, APOL, LCAT).
  • Examination of LCAT deficiency as a model for CKD-associated lipid abnormalities.

Main Results:

  • CKD is associated with dysfunctional HDL particles that lose protective functions.
  • Genetic defects in HDL metabolism, particularly LCAT deficiency, mirror lipid abnormalities seen in CKD.
  • Reduced HDL-C levels are a significant indicator of CKD progression.

Conclusions:

  • HDL dysfunction plays a critical role in CKD pathogenesis and progression.
  • Genetic factors influencing HDL metabolism are implicated in kidney disease.
  • Modulating the HDL system presents a potential therapeutic avenue for managing CKD.

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