Chronic kidney disease stage affects small, dense low-density lipoprotein but not glycated low-density lipoprotein in younger chronic kidney disease patients: a cross-sectional study

Abstract

BackgroundSmall, dense low-density lipoprotein (sd-LDL) and glycated LDL (g-LDL) have been associated with cardiovascular disease (CVD) in chronic kidney disease (CKD) in patients >60 years of age. Since young adult and paediatric patients have shorter exposure to Framingham-type risk factors, our study aims to determine whether younger CKD patients exhibit the same sd-LDL and g-LDL pattern.MethodsAfter ethics board approval, this cross-sectional study was conducted at two universities with 44 patients (mean ± standard deviation age 12.6 ± 4.9, range 2–24 years) with CKD stage of 1–5. Laboratory parameters studied were Cystatin C (CysC), CysC estimated glomerular filtration rate (eGFR) (calculated from the Filler formula), sd-LDL, g-LDL and albumin. Lipid samples were measured for sd-LDL and g-LDL using ELISA. Non-linear correlation analysis was performed to determine the relationship between g-LDL, sd-LDL and eGFR. Clinical Trials Registration is at clinicaltrials.gov, NCT02126293, https://clinicaltrials.gov/ct2/show/NCT02126293.ResultsTriglycerides, but not total cholesterol and calculated LDL, were associated with CKD stages (ANOVA P = 0.0091). As in adults, sd-LDL was significantly associated with CKD stages (ANOVA P = 0.0133), CysC eGFR (r = −0.6495, P < 0.00001), and body mass index (r = −0.3895, P = 0.0189), but not with age. By contrast, there was no significant correlation between g-LDL and CKD stages or CysC eGFR (P = 0.9678).ConclusionsOur study demonstrates that only triglycerides and sd-LDL were associated with CKD stages in this young cohort without confounding Framingham-type CVD risk factors. While larger studies are needed, this study suggests that lowering sd-LDL levels may be a potential target to ameliorate the long-term CVD risks in paediatric CKD patients.

Chronic Kidney Disease as Oxidative Stress- and Inflammatory-Mediated Cardiovascular Disease

“…They determined whether younger CKD patients have the same sd-LDL and g-LDL-C pattern as adults with CKD. They demonstrated that only TG and sd-LDL were associated with CKD stages among young patients without Framingham-type CVD risk factors and suggested that lowering sd-LDL levels may be a potential target to improve the long-term CVD risk in young patients with CKD [165].…”

Atherosclerosis Development and Progression: The Role of Atherogenic Small, Dense LDL

“…Increased prevalence of sdLDLs is common in CKD [48]. Importantly, it has been shown that the quantity of sdLDL particles is associated with the disease stage in both adult and young CKD patients [49,50]. In addition, sdLDL-cholesterol level was identified as an independent risk factor for CVD development in subjects with CKD [44].…”

Narrative Review of Carotid disease and the kidney

“…However, it is difficult to dissect the role of CKD from the cluster of risk factors that may accompany carotid atherosclerosis (e.g., hypertension, diabetes, dyslipidaemia and inflammation) in these patients (49)(50)(51). In this context, qualitative and quantitative lipid abnormalities have been reported in these patients (52)(53)(54)(55) and linked to both carotid atherosclerosis (55)(56)(57)(58) and CKD progression (59). Moreover, blood pressure, haemoglobin and several mineral metabolism parameters predict carotid atherosclerosis progression in CKD patients (60,61).…”