NDT Advance Access published online on September 2, 2005
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfi068
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1 Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, Groningen, The Netherlands
* To whom correspondence should be addressed. Background. Lipid derangements are assumed to contribute to the elevated cardiovascular risk in proteinuric patients. The impact of proteinuria on reverse cholesterol transport (RCT) is unknown. The first step in RCT, cellular cholesterol efflux to plasma, may be altered in proteinuria, consequent to changes in pre- Methods. In six non-diabetic male patients with nephrotic-range proteinuria and 12 matched healthy men, plasma (apo)lipoproteins, pre- Results. Plasma total cholesterol (P<0.05), triglycerides (P<0.05), apolipoprotein (apo) A-I (P<0.001), apo B (P<0.001), PLTP activity (P<0.005) and pre- Conclusion. Cellular cholesterol efflux to plasma from patients with nephrotic-range proteinuria is enhanced, in conjunction with elevated pre-
Received April 15, 2005
Accepted July 20, 2005
Original Articles
Cellular cholesterol efflux to plasma from proteinuric patients is elevated and remains unaffected by antiproteinuric treatment
2 Division of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands; Department of Cell Biology & Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
3 Department of Experimental Hepatology, Academic Medical Center, Amsterdam, The Netherlands
4 Division of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
Liffert Vogt, E-mail: liffertvogt{at}hotmail.com
Abstract 
high-density lipoprotein (HDL) formation and plasma phospholipid transfer protein (PLTP) activity. HDL formation, PLTP activity as well as the ability of plasma to promote cholesterol efflux out of cultured human skin fibroblasts were determined. These variables were also measured in response to antiproteinuric treatment, consisting of single and dual RAAS blockade by losartan and lisinopril. HDL formation (P<0.001) were higher in proteinuric patients. Cellular cholesterol efflux to plasma from proteinuric patients was 41% higher than to plasma from healthy subjects (P<0.001). Reduction of proteinuria from 5.0 to 1.4 g/day by dual RAAS blockade was associated with a 23% reduction in plasma apo B levels (P<0.05). Pre- HDL formation and plasma PLTP activity did not change significantly. Combined antiproteinuric treatment did not reduce the elevated cellular cholesterol efflux. HDL formation and plasma PLTP activity. These changes may attenuate the cardiovascular risk associated with proteinuria-associated hyperlipidaemia. Antiproteinuric therapy lowers plasma apo B, but does not affect cell-derived cholesterol efflux, suggesting that this therapy beneficially affects cardiovascular risk in proteinuric patients. HDL; proteinuria.
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