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NDT Advance Access published online on February 5, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp026
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Low-density lipoprotein clearance in patients with chronic renal failure

Helena Kastarinen1,2, Sohvi Hörkkö2,3, Heikki Kauma1,2, Anna Karjalainen1,2, Markku J. Savolainen1 and Y. Antero Kesäniemi1,2

1 Institute of Clinical Medicine, Department of Internal Medicine 2 Biocenter Oulu 3 Department of Pharmacology and Toxicology, University of Oulu, and Clinical Research Center, Oulu University Hospital, Oulu, Finland

Correspondence and offprint requests to: Y. Antero Kesäniemi, Department of Internal Medicine, University of Oulu, PO Box 20, FIN-90029 OYS, Oulu, Finland. Tel: +358-8-3154100; Fax: +358-8-3155423; E-mail: antero.kesaniemi{at}oulu.fi



  Abstract

Background. Chronic renal failure increases the risk of atherosclerosis. The clearance of low-density lipoprotein (LDL), a major risk factor for atherosclerosis, has been reported as being disturbed in dialysis patients. We studied LDL metabolism in non-dialyzed patients with chronic kidney disease (CKD).

Methods. LDL clearance was studied with a radiotracer method in 57 CKD patients and 10 healthy controls.

Results. In the CKD patients, the fractional catabolic rate of LDL apo B (LDL FCR), an indicator of LDL clearance from plasma, ranged from 0.13 to 0.56 pools/day with a mean value of 0.34 pools/day being comparable to that of the control subjects. In the renal patients, LDL FCR correlated significantly with estimated glomerular filtration rate (eGFR) (r = 0.340, P = 0.010) and this association remained significant after the adjustment with age, body mass index, gender, presence of diabetes and LDL cholesterol concentration (P = 0.004). In CKD patients with eGFR <15 mL/min/1.73 m2 the mean LDL FCR was significantly reduced when compared to that of CKD patients with eGFR >30 mL/min/1.73 m2 (P = 0.005). LDL apo B production rate was not associated with renal function or different between renal patients and control subjects.

Conclusions. The clearance of LDL seems to be related to the severity of renal impairment, but a remarkable reduction in LDL catabolism can be observed only in patients with advanced renal failure.

Keywords: chronic renal failure; LDL cholesterol; lipoprotein metabolism

Received for publication: 14.10.08
Accepted in revised form: 13. 1.09


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