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Decrease of serum paraoxonase activity in chronic renal failure

T F Dantoine1, J Debord, J P Charmes

  • 1Nephrology Unit, Dupuytren University Hospital, Limoges, France.

Journal of the American Society of Nephrology : JASN
|November 10, 1998
PubMed
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Paraoxonase activity, an enzyme protecting against cardiovascular disease, is reduced in patients with chronic kidney disease, especially those on dialysis. Renal transplantation appears to restore this vital enzyme activity.

Area of Science:

  • Biochemistry
  • Nephrology
  • Cardiology

Background:

  • Paraoxonase is an HDL-associated esterase that hydrolyzes organophosphates and may protect LDL from peroxidation, contributing to HDL's antiatherogenic effects.
  • Low paraoxonase activity is linked to cardiovascular conditions like myocardial infarction, diabetes mellitus, and familial hypercholesterolemia.
  • Cardiovascular disease is a leading cause of mortality in patients with chronic renal failure.

Purpose of the Study:

  • To investigate serum paraoxonase activity in patients with various stages of kidney disease.
  • To compare paraoxonase activity in kidney disease patients with age-matched control groups.
  • To assess the impact of renal failure, dialysis, and transplantation on paraoxonase activity.

Main Methods:

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  • Serum paraoxonase activity was measured using spectrophotometry with three synthetic substrates: phenyl acetate, paraoxon, and 4-nitrophenyl acetate.
  • The study included 305 patients with kidney disease (chronic renal failure, hemodialysis, peritoneal dialysis, renal transplant recipients) and 195 age-matched controls.
  • Statistical analysis compared paraoxonase activity across patient groups and controls.

    • Main Results:

    • Paraoxonase activity, particularly with 4-nitrophenyl acetate, was significantly lower in patients with chronic renal failure, hemodialysis, and peritoneal dialysis compared to controls.
    • No significant difference in paraoxonase activity was observed between renal transplant patients and control subjects.
    • A decrease in paraoxonase activity was noted in renal insufficiency, especially with dialysis treatments.

    Conclusions:

    • Reduced paraoxonase activity in chronic kidney disease, particularly during dialysis, may contribute to premature vascular aging and increased cardiovascular risk.
    • Renal transplantation seems to normalize or restore paraoxonase activity.
    • Paraoxonase activity levels could serve as a biomarker for cardiovascular risk in chronic kidney disease patients.