Nephrology Dialysis Transplantation, Vol 13, Issue 9 2281-2287, Copyright © 1998 by Oxford University Press
I Rajman, L Harper, D McPake, M Kendall and D Wheeler
Background: Small low-density lipoprotein (LDL)
particle size, a newly recognized risk factor for cardiovascular disease in
the general population, is frequently associated with
hypertriglyceridaemia, the predominant plasma lipid abnormality present in
uraemia. Methods: Plasma lipids and LDL subfraction
profiles were examined in 33 non-dialysed patients with chronic renal
failure (predial), 40 patients on continuous ambulatory peritoneal dialysis
(CAPD), 42 haemodialysis patients (HD), 47 renal transplant recipients
(RTR), and 44 controls. LDL subfractions separated by gel electrophoresis
were scored by densitometric analysis (higher scores indicate profiles
comprising smaller particles). Results: All groups
with renal failure had significantly elevated (mean±SD) LDL
scores (predial 1.36±0.6, CAPD 1.71±0.9, HD
1.68±0.9, RTR 1.92±0.8 vs
control 0.87±0.4, all P<0.001), this being the only lipid
abnormality detected in the predialysis patients. In CAPD and HD patients,
LDL scores were associated with serum triglyceride (r=0.81, P<0.0001
and r=0.70, P<0.01 respectively), cholesterol (r=0.55,
P<0.001 and r=0.49, P<0.01) and HDL-cholesterol (r=-0.43,
P<0.01 and r=-0.51, P<0.01), whilst no such relationship was
seen in the predialysis and RTR groups, suggesting that other factors were
important. Conclusions: The presence of small LDL
particles appears to be an early and unexplained feature of the uraemic
dyslipidaemia. This abnormality persists after renal transplantation and
may represent an important atherogenic risk factor. Key
words: LD subfractions; renal failure; transplants
ORIGINAL ARTICLES
Low-density lipoprotein subfraction profiles in chronic renal failure
Clinical Investigation Unit, Nephrology Department, Queen Elizabeth Hospital, Birmingham, UK; Corresponding author at: Clinical Pharmacology, Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Windlesham, Surrey GU20 6PH, UK
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