Lipid and lipoprotein status in hemodialysed patients

Authors

DOI:

https://doi.org/10.12923/

Keywords:

lipids, lipoproteins, hemodialysis, cardiovascular disease

Abstract

The main cause of increased morbidity and mortality among patients on maintenance hemodialysis is a cardiovascular complications due to accelerated atherosclerosis. The aim of this study was to evaluate parameters of lipid and lipoprotein profile, lipid and lipoprotein ratios and oxidative stress parameter for better understanding the feature of dyslipidemia in hemodialysed patients. The studies were performed in 12 hemodialysed patients at the age between 21–60 and a reference group (n=18). The venous blood after 14-hour fasting was taken to commercial tubes and centrifuged at 3000 rpm at 4oC immediately after blood collection. Routine laboratory parameters (the level of urea, creatinine, total protein, albumin) were measured using Au 400 analyzer (Olimpus), and hemoglobin using ADVIA analyser, Bayer with using standard techniques. Lipids and lipoproteins were determined on Hitachi 902 analyser with standard techniques. The total concentration of peroxides was measured as Oxy-Stat by using ELISA method (Biomedica, Viena). The total cholesterol (TC) was estimated using the enzymatic-colorimetric method, triglycerides (TG) were determined using the standard enzymatic technique (BIOMAXIMA), HDL-C with the direct method with immunoinhibition (AB-WAKO - BIOMAXIMA). Non-HDL-C and a TC minus HDL-C, LDL-C with using Friedewald formula, lipids (TC/HDL-C, TG/HDL-C, LDL-C/HDL-C) and lipoprotein ratios (apoAI/apoB, HDL-C/apoAI) were calculated. Studied HD patients presented normotriglicerydemia but HDL-C and apoAI concentrations were significantly decreased when compared to the reference group, which corroborates in disturbed lipid and lipoprotein ratios. Significantly higher TC/HDL-C, LDL-C/HDL-C, TG/HDL-C ratios and significantly lower HDL-C/apoAI and apoAI/apoB and are noticed in the studied patients than for the reference group. An increased concentration of oxidative stress parameter-Oxy Stat was also presented. Decreased HDL-C and apoAI concentrations suggest disturbed composition and function of HDL lipoprotein particle which together with increase oxidative may accelerate premature atherosclerosis in hemodialised patients.

References

1. Akdag I. et al.: Clinical value of the malnutrition-inflammation-atherosclerosis syndrome for long-term prediction of cardiovascular mortality in patients with end-stage renal disease: a 5-year prospective study. Nephron. Clin. Prct., 108, 99, 2008.

2. Chan D.T., Irish A.B., Dogra C.K., Watts G.F.: Dyslipiemia and cardiorenal disease: mechanisms, therapeutic opportunities and clinical trials. Atherosclerosis, 196, 823, 2008.

3. Chmielewski M., Carrero J.J., Nordfors L. et al.: Lipid disorders in chronic kidney disease: reverse epidemiology and therapeutic approach. J. Nephrol., 21, 635, 2008.

4. Hałabiś M., Kimak E.: HDL as a risk factor for cardiovascular disease in healthy people. Annales UMCS, Sect. DDD, 1, 349, 2008.

5. Kalantar-Zadeh K., Block G., Humpreys M.H., Kopple J.D.: Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patiernts. Kidney Int., 63, 793, 2003.

6. Kaysen G.A.: Potential restoration of HDL function with apolipoprotein A-I mimetic peptide in end-stage renal disease Kidney Int., 76 (comment.), 359, 2009.

7. Kimak E., Hałabiś M.: Serum hypertriglycerydemia as an important risk factor of chronic allograft failure in post renal-transplant patients. Annales UMCS, Sect. DDD, 1, 115, 2009.

8. Kimak E., Hałabiś M., Baranowicz-Gąszczyk I.: Relationships between serum lipid, lipoprotein triglyceride-rich lipoprotein, and high-density lipoprotein particle concentration in post-renal transplant patients. J. Zhejiang. Univ. Sci. B, 11, 249, 2010.

9. Kimak E., Solski J., Janicka L. et al.: Concentration of Lp(a) and other apolipoproteins in predialysis, hemodialysis, chronic ambulatory peritoneal dialysis and post-renal transplant patients. Clin. Chem. Lab. Med., 38, 421, 2000.

10. Kronenberg F., Lingenhel A., Neyer U. et al.: Prevalence of dyslipidemic factors in hemodialysis and CAPD patients. Kidney Int. Suppl., 84, 113, 2003.

11. Masuda R., Imamura H., Mizuuchi K. et al.: Physical Activity, High-Density Lipoprotein Cholesterol Subfractions and Lecithin:Cholesterol Acyltransferase in Dialysis Patients. Nepchron. Clin. Pract., 11, 253, 2009.

12. Mekki K., Prost J., Bouchenak M. et al.: Plasma lipoprotein lipase, hepatic lipase activities, VLDL, LDL compositions at different times of hemodialysis. Atherosclerosis, 169, 269, 2003.

13. Mekki K., Prost J., Remaoun M. et al.: Long term hemodialysis aggravates lipolytic activity reduction and vary low density, low density lipoproteins composition in chronic renal failure patients. BMC Cardiovascular Disorders, 9, 41, 2009.

14. Montague T., Murphy B.: Lipid management in chronic kidney disease, hemodialysis and transplantation. Endocrinol. Metab. Clin. N. Am., 38, 223, 2009.

15. Monzani G. et al.: Lipoprotein abnormalities in chronic renal failure and dialysis patients. Blood Purif., 14, 262, 1996.

16. Morena M., Cristol J.P., Dantoine T. et al.: Protective affects of high-density lipoprotein against oxidative stress are impaired in hemodialysis patients. Nephrl. Dial. Transplant., 5, 389, 2000.

17. Piecha G., Adamczak M., Ritz E.: Dyslipidemia in chronic kidney disease. Patochegenesis and intervention. Pol. Arch. Med. Wew., 119, 487, 2009.

18. Prichard S.S.: Impact of dyslipidemia in end-stage renal disease. J. Am. Soc. Nephrol., 14, 315, 2003.

19. Ramos R., Martinez-Castelao A.: Lipoperoxidation and hemodialysis. Metab. Clin. Exp., 57, 1369, 2008.

20. Schiffl H., Lang S.M.: Effects of Dialysis purity on Uremic Dyslipidemia. Therapeutic Apheresis and Dialysis, 14, 5, 2009.

21. Tsimihodimos V., Dounousi E., Siamopoulos K.C.: Dyslipidemia in chronic kidney disease: an approach to pathogenesis and treatment. Am. J. Nephrol., 28, 958, 2008.

22. WonSuk A., Seong-Eun K., Ki-Hyum K. et al.: Association between Oxidized LDL and LDL Ratio, HDL and Vascular Calcification in the Feet of Hemodialysis Patients. J. Korean Med. Sci., 24, 115, 2009.

23. Wanner C., Krane V.: Uremia-specific alternations in lipid metabolism. Bood Purif., 20, 451, 2002.

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Published

2025-04-09

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Vol. 23 No. 2 (2010): Annales UMCS, Pharmacia, Sectio DDD, Volume XXIII

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Artykuły

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