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Decreased clearance of low-density lipoprotein in uremic patients under dialysis treatment

S Hörkkö1, K Huttunen, Y A Kesäniemi

  • 1Department of Internal Medicine, University of Oulu, Finland.

Kidney International
|June 1, 1995
PubMed

Insights

Low-density lipoprotein (LDL) clearance is reduced in uremic patients undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). This impaired LDL metabolism may accelerate atherosclerosis in dialysis patients.

Area of Science:

  • Nephrology
  • Cardiovascular Metabolism
  • Lipidology

Background:

  • Uremic patients often exhibit dyslipidemia, a known risk factor for cardiovascular disease.
  • Altered lipid metabolism, particularly low-density lipoprotein (LDL) clearance, is suspected in patients with chronic kidney disease.

Purpose of the Study:

  • To compare LDL clearance rates in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) versus healthy controls.
  • To investigate the relationship between LDL clearance and plasma lipid levels in uremic patients.

Main Methods:

  • Assessed fractional catabolic rate (FCR) for LDL in 11 HD patients, 9 CAPD patients, and 9 control subjects.
  • Correlated LDL FCR with plasma total cholesterol, LDL cholesterol, and LDL apolipoprotein B concentrations.

Main Results:

  • Overall LDL clearance (FCR) was significantly lower in uremic patients (0.305 pools/day) compared to controls (0.376 pools/day; P=0.01).
  • CAPD patients showed markedly reduced LDL clearance (0.268 pools/day) compared to controls (P=0.001).
  • LDL clearance negatively correlated with plasma total cholesterol (r=-0.56), LDL cholesterol (r=-0.76), and LDL apolipoprotein B (r=-0.48).

Conclusions:

  • Dialysis treatment impairs LDL clearance in uremic patients.
  • Reduced LDL catabolism in uremia may contribute to the increased risk of atherosclerosis observed in these individuals.

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