The effect of decreasing renal function on lipoprotein profiles

Abstract

Progressive chronic kidney disease (CKD) is accompanied by dyslipidemia that is characterized by increased concentrations of intact and partially metabolized ApoB and ApoC-III-containing triglyceride-rich lipoproteins in very low-density lipoprotein, intermediate density lipoprotein (IDL) and low-density lipoprotein. The purpose of the present study was to characterize the distribution of individual discrete lipoprotein subclasses in relation to the glomerular filtration rate (GFR) in nondiabetic CKD subjects. Fifty-one subjects (33 patients with CKD and 18 asymptomatic subjects) with GFR ranging from 12 to 120 mL/min were studied. Individual ApoA- and ApoB-containing lipoprotein subclasses (Lp) were determined in plasma by sequential immunoaffinity chromatography and subsequent determination of apolipoprotein composition by electroimmunoassays. GFR was measured as plasma clearance of iohexol or (51)Cr-ethylenediaminetetraacetic acid. There were no changes in concentrations of ApoA-containing lipoproteins with decreasing GFR. The levels of ApoB-containing lipoproteins increased significantly with decreasing GFR. There was a moderate increase of cholesterol-rich LpB and a 3-fold increase of ApoB- and ApoC-III-containing lipoproteins in subjects in the two lowest quintiles of GFR. This was accompanied by a significant increase of plasma ApoC-III. Reduced renal function is associated with a complex alteration of the lipoprotein profile that is predominantly characterized by increased concentrations of triglyceride-rich lipoprotein subclasses containing both ApoB and ApoC-III.