Impaired Intestinal Fat Absorption in Chronic Renal Failure

Drukker, Alfred; Lévy, E; Bronza, Naomi; Stankiewicz, H; Goldstein, Robert H.

doi:10.1159/000182453

Cited by 12 publications

(4 citation statements)

References 12 publications

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“…Our findings are not that surprising considering the broad range of uremia-related gastrointestinal abnormalities reported in literature, including gastrointestinal motility disorders [37][38][39][40][41], small bowel bacterial overgrowth [42,43], gastric hypochlorhydria [26,37,44], and uremic pancreopathy [44][45][46][47][48][49][50][51][52]. Each of them could theoretically disturb protein digestion and/or absorption.…”

Section: Discussionmentioning

confidence: 80%

Evidence for impaired assimilation of protein in chronic renal failure

Bammens¹,

Verbeke²,

Vanrenterghem³

et al. 2003

Kidney International

109

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Section: Discussionmentioning

confidence: 80%

Evidence for impaired assimilation of protein in chronic renal failure

Bammens¹,

Verbeke²,

Vanrenterghem³

et al. 2003

Kidney International

109

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“…Whereas there is no widespread indication from clinical practice of a significant alteration in intestinal fat absorption [109], this may in fact occur [110,111]. Regardless, in studies of patients with CRI, there is a greater rise and an abnormally prolonged increase in circulating triglycerides postprandially [112,113].…”

Section: Postprandial Lipoproteins and Effects Of Crimentioning

confidence: 99%

Lipoprotein metabolism in chronic renal insufficiency

Saland

Ginsberg

2007

Pediatr Nephrol

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Chronic renal insufficiency (CRI) is associated with a characteristic dyslipidemia. Findings in children with CRI largely parallel those in adults. Moderate hypertriglyceridemia, increased triglyceride-rich lipoproteins (TRL) and reduced high-density lipoproteins (HDL) are the most usual findings, whereas total and low-density lipoprotein cholesterol (LDL-C) remain normal or modestly increased. Qualitative abnormalities in lipoproteins are common, including small dense LDL, oxidized LDL, and cholesterol-enriched TRL. Measures of lipoprotein lipase and hepatic lipase activity are reduced, and concentrations of apolipoprotein C-III are markedly elevated. Still an active area of research, major pathophysiological mechanisms leading to the dyslipidemia of CRI include insulin resistance and nonnephrotic proteinuria. Sources of variability in the severity of this dyslipidemia include the degree of renal impairment and the modality of dialysis. The benefits of maintaining normal body weight and physical activity extend to those with CRI. In addition to multiple hypolipidemic pharmaceuticals, fish oils are also effective as a triglyceride-lowering agent, and the phosphorous binding agent sevelamer also lowers LDL-C. Emerging classes of hypolipidemic agents and drugs affecting sensitivity to insulin may impact future treatment. Unfortunately, cardiovascular benefit has not been convincingly demonstrated by any trial designed to study adults or children with renal disease. Therefore, it is not possible at this time to endorse general recommendations for the use of any agent to treat dyslipidemia in children with chronic kidney disease.

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“…There are only a few studies that address cholesterol homeostasis and its relationship with cardiovascular risk within CKD or HD populations. CKD patients were reported to have impaired intestinal fat absorption [34]. In a study on eight HD patients, investigators reported that HD patients demonstrated significantly lower fractional cholesterol synthesis (lathosterol) and lower lathosterol to cholesterol ratio compared to healthy controls [16].…”

Section: Discussionmentioning

confidence: 99%

Associations between Circulating Markers of Cholesterol Homeostasis and Macrovascular Events among Patients Undergoing Hemodialysis

et al. 2021

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Current strategies targeting serum cholesterol bring limited benefits to mortality and macrovascular events prevention among hemodialysis patients. Direct measurements and analysis on circulating markers of cholesterol homeostasis could be promising solutions to this bottleneck. We prospectively enrolled 90 maintenance hemodialysis patients and 9 healthy controls in 2019 for 1 year. We measured circulating desmosterol and lathosterol as markers for cholesterol synthesis and campesterol and sitosterol for cholesterol absorption. At baseline, hemodialysis patients showed higher levels of campesterol (p = 0.023) compared to healthy controls. During follow-up, we identified 14 (15.4%) patients who experienced macrovascular events. Comparisons of cholesterol homeostasis markers between cohorts with and without macrovascular events showed no significant differences in markers of cholesterol synthesis or absorption. Using logistic regression analysis, the odds ratio was not statistically significant for the prediction of macrovascular events after full-adjusting for age, sex, diabetes, serum albumin, cholesterol, and triglyceride. We concluded that hemodialysis patients demonstrated higher level of cholesterols absorption, indicated by circulating campesterol compared to healthy subjects. Markers for cholesterol homeostasis were not significantly associated with macrovascular events during a 1-year follow-up. Our results shed light on the novel therapeutic target of modulating cholesterol absorption in HD patients.

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Impaired Intestinal Fat Absorption in Chronic Renal Failure

Cited by 12 publications

References 12 publications

Evidence for impaired assimilation of protein in chronic renal failure

Evidence for impaired assimilation of protein in chronic renal failure

Lipoprotein metabolism in chronic renal insufficiency

Associations between Circulating Markers of Cholesterol Homeostasis and Macrovascular Events among Patients Undergoing Hemodialysis

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