Cholesteryl ester transfer in patients with renal failure or renal transplants

Plasma newly-synthesized cholesteryl ester transfer (NCET) rate and concentrations of lipids, lipoproteins and apolipoproteins A1 and B were measured in chronic renal failure patients (dialysis independent and dialysis dependent), patients with a functioning renal transplant and in healthy control subjects with comparable ages and plasma triglycerides. Plasma NCET rates and apoB concentrations were significantly higher in patients treated by continuous ambulatory peritoneal dialysis (CAPD) compared with controls. In normolipidemic subjects (cholesterol < 6.5 mmol/liter, triglycerides < 2.0 mmol/liter), plasma NCET rates did not differ significantly from rates in the corresponding control subjects. In hyperlipidemic subjects, plasma NCET rates were significantly higher than rates in the normolipidemic subgroup. Plasma NCET rates were correlated closely with plasma apoB levels in all renal patients combined (r = 0.754, N = 53, P < 0.001) and with plasma cholesteryl ester mass transfer (r = 0.853, N = 13, P < 0.001). We conclude that, in the absence of hyperlipidemia, plasma NCET rate is normal in patients with chronic renal failure irrespective of the treatment for uremia, and when hyperlipidemia is present NCET rates are raised and may contribute to elevated levels of the proatherogenic apoB-containing lipoproteins.