Lipoprotein abnormalities: A potential consequence of chronic kidney disease

Abstract

: Chronic kidney disease (CKD) is marked by kidney damage or a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m for at least three months, regardless of the underlying etiology. When a variety of renal problems are present, albuminuria defined as an albumin-to-creatinine ratio >30 mg/g in two out of three spot urine samples can serve to determine kidney failure.The estimated global rate of CKD is 13.4%. Nearly every aspect of biological life involves lipids. A few of these include acting as hormones or as precursors to hormones, providing energy, storing function and metabolic fuels, acting as functional and structural molecules in bio-membranes and forming insulation to aid in nerve transmission or prevent heat loss. The blood contains a variety of lipoproteins. They are chylomicrons, very-low density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL), in descending sequence of increasing density. Less dense lipoproteins result from lower protein/lipid ratios. Although some lipoproteins carry cholesterol in its natural "free" alcohol form (the cholesterol-OH group facing the water surrounding the particles), all lipoproteins contain identical amounts of cholesterol. Other lipoproteins carry cholesterol in the form of fatty acyl esters, sometimes referred to as cholesterol esters. Triacylglycerol and cholesterol, which were not employed in the production of bile acids, are converted by the liver into VLDL molecules. The aim of the study was to assess the Lipid levels in CKD and study the correlation between eGFR (which is a marker of severity of CKD) and lipid levels in CKD. Thepresent study was an observational study. The study was conducted over a period of six months on 180 patients. Blood samples were obtained in Becton Dickinson's commercially available red-capped tubes vacutainers (BD). After that, blood samples were left undisturbed at room temperature for 15-30 minutes to coagulate. For 5 minutes, the tubes were centrifuged at 3000 rpm. After centrifugation, the sample solution (serum) was transferred to a fresh polypropylene tube with a Pasteur pipette. Lipid profile and serum creatinine were done on fully automated SYSMEX BX-3010. Our results show that mean and standard deviation of serum cholesterol, serum triglycerides, HDL, VLDL and LDL with -value between males and females in the different stages of CKD shows a statistically significant difference between stage II, III B, IV and stage V. The present study highlights the progressive increase in serum cholesterol, serum triglycerides, VLDL, LDL levels as CKD advances through its stages. A progressive decline in HDL levels as CKD also advances through its stages. The correlations between eGFR and various biomarkers in the stages of CKD shed light on the complex interactions between renal function, lipid metabolism.