The Japanese Journal of Clinical Dialysis Vol.14 No.11(3-2)

Theme Pathophysiology and Treatment of Deranged Lipid Metabolism in Chronic Renal Failure
Title Intermediate density lipoprotein (IDL) in patients with renal failure -- Including glomerulonephritis
Publish Date 1998/09
Author Yoji Nishida Second Department of Internal Medicine, Hiroshima University School of Medicine
Author Noriaki Yorioka Second Department of Internal Medicine, Hiroshima University School of Medicine
[ Summary ] Intermediate density lipoprotein (IDL), which does not exist in the plasma of healthy subjects, is detected in high incidence in the plasma of patients with familial hyperlipidemia (particularly TypeIII), nephrotic syndrome, diabetes mellitus, chronicrenal failure, and patients who receive dialysis. IDL has also been reported to be a factor in the development and progression of atherosclerosis. We previously reported that various types of lipoproteins cause the in vitro proliferation of mesangial cells, and suggested that this effect is mediated by cytokines. In this paper, we report the results of a clinical investigation on the effect of the presence of IDL in the plasma of patients with nephritis and renal failure. This study involved 91 patients with chronic glomerulonephritis, which included 55 patients with IgA nephropathy. The results showed that the glomerular filtration rate in patients whose plasma contains IDL, was significantly lower than that in patients whose plasma does not contain IDL. In addition, the level of daily total protein in the urine of patients whose plasma contains IDL, was significantly higher than that of patients whose plasma does not contain IDL. We also found that in patients with IgA nephropathy there was a significant correlation between the relative percentage of IDL in the plasma and the degree of histological damage. These results suggest that IDL accumulates in the plasma of patients who have chronic nephropathy and patients who have renal failure. The presence of IDL in the plasma may cause the adverse effects on the glomerulus seen in these patients, such as glomerulosclerosis.
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