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Nephrol Dial Transplant (1999) 14: 2664-2668
© 1999 European Renal Association-European Dialysis and Transplant Association

Disturbed LDL and scavenger receptor functions in monocytes from chronic haemodialysed patients

István Kárpáti1, György Paragh1, Éva Kovács1, Zoltán Balogh1, Márton Szabolcs2, Jenõ Szabó1, György Kakuk1 and Gabriella Fóris2

1 First Department of Medicine and 2 Central Research Laboratory, University Medical School of Debrecen, Debrecen, Hungary

Correspondence and offprint requests to: Éva Kovács, First Department of Medicine, University Medical School of Debrecen, Debrecen, H-4012, Hungary.

Background. The most frequent complication in patients with end-stage renal failure on chronic haemodialysis (HD) treatment is atherosclerosis, i.e. the different forms of heart and vascular diseases. The complete disorder of serum lipid and lipoprotein patterns is well demonstrated, whereas our knowledge about the low-density lipoprotein (LDL) and scavenger receptor expression and function are poorly understood.

Methods. In our current work, LDL and scavenger receptor expression and functions were simultaneously studied in monocytes obtained from 15 healthy male control subjects and from 11 chronic HD male patients applied with 125I-labelled LDL, isolated from healthy volunteers. To study the scavenger LDL receptors, labelled acetylated LDL (acLDL) was used.

Results. LDL binding to the monocytes of the HD-group was found to be decreased in comparison to that of the controls. As a result, the 50 µg LDL protein-induced inhibition of endogenous cholesterol synthesis was also diminished. In contrast, acLDL binding was greatly increased, though it could trigger only a low apoE synthesis. Consequently the number of cholesterol inclusions in monocytes was increased.

Conclusions. The disturbed expression and function of LDL and scavenger receptors both may play significant roles in pathogenesis of cardiovascular complications in chronic HD patients. Based on our present results, it can be assumed that dysfunction of scavenger receptors is at the centre of cardiovascular complications of HD patients with renal failure.

Keywords: cholesterol synthesis; foam cell; haemodialysis; LDL receptor; monocyte; scavenger receptor


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