Lipoprotein metabolism abnormalities in patients with chronic renal insufficiency

Patients with chronic renal insufficiency on hemodialysis develop lipoprotein abnormalities that may contribute to increased risk for atherosclerosis. The atherogenic risk for chronic renal insufficiency patients and dialysis treated patients was assessed by measuring total cholesterol, triglycerides HDL-cholesterol, LDLcholesterol and calculating the ratio: TC/HDL-C and LDL-C/HDL-C. The examined group consisted of 18 cronic renal insufficiency patients and 60 patients on hemodialysis. The results were compared to a control group of 85 voluntary blood donors. Serum lipid parameters were examined by standard methods. All lipid parameters in hemodialysis patients were statistically different compared to the control group (p<0.05) while chronic renal insufficiency patients showed significant difference only in triglycerides and HDL-cholesterol. Hypertriglyceridemia was present in both examined groups of patients and HDL-cholesterol was lower within both groups. All calculated atherogenic ratios were higher for patients than the control group. Lipid parameters were compared between chronic renal insufficiency and hemodialysis patients but statistical significantly difference was obtained only for HDL-cholesterol (p<0.05). We conclude that increased values of triglycerides and lower HDL-cholesterol in chronic renal insufficiency patients contribute to high incidence of cardiovascular disease. Chronic renal insufficiency patients have impaired reverse cholesterol transport from peripheral cells to lipoproteins, decreased levels of HDL-cholesterol hypertriglyceridemia prevalence of small, dense LDL and increased levels of potentially atherogenic remnant particles.