Chronic Kidney Disease - Different Role for HDL?
Rysz Jacek, Gluba Anna, Fliser Danilo, Speer Timo and Wiecek Andrzej
Affiliation: Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Poland.
Keywords: Atherosclerosis, CAD risk, chronic kidney disease, dysfunctional HDL.
Chronic kidney disease (CKD) is an emerging health hazard, connected to very high cardiovascular mortality
due to accelerated atherosclerosis. Increased cardiovascular risk cannot be explained only by traditional risk factors. Patients
with renal dysfunction have significant disturbances in lipoprotein metabolism and HDL in these patients becomes
dysfunctional. It has been documented that in patients with CKD lower plasma level of HDL cholesterol and reduced ability
of HDL to bind to ABCA1 are seen, which result in slowing down the reverse cholesterol transport and disturbances in
HDL maturation due to decreased lecithin cholesterol ester transfer protein. Studies demonstrated that HDL of CKD patients
loses its vasoprotective, antioxidative and anti-inflammatory properties and turns into a noxious particle which promotes
endothelial dysfunction via stimulating superoxide production and limiting NO bioavailability. Alterations of HDL
at the ‘molecular and functional level’ are also seen in renal transplant recipients even in those with excellent graft function.
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