| Theme |
Pathophysiology and Treatment of Deranged Lipid Metabolism in Chronic Renal Failure |
| Title |
Small dense LDL in patients with renal failure |
| Author |
Tsutomu Hirano |
First Department of Internal Medicine, Showa University School of Medicine |
| [ Summary ] |
Small low-density lipoprotein (LDL) is associated with a high incidence of coronary heart disease and may play a role in the progression of glomerulosclerosis. It is well known that a strong inverse correlation exists between LDL size and plasma triglyceride (TG) levels. LDL particles become smaller in patients with kidney disease and this is closely associated with plasma TG concentrations. Patients treated with hemodialysis do not exhibit this small-dense LDL unless the subjects are hypertriglyceridemic. LDL size is substantially smaller in patients with diabetic nephropathy, even when hypertriglyceridemic subjects are excluded. NIDDM patients receiving nephropathy exhibit marked postprandial lipemia, which is associated with the reduction LDL size, independent of fasting TG levels. We should pay more attention to plasma TG levels in patients with kidney disease, because LDL size is strongly regulated by its concentration. |