Patients with chronic kidney disease (CKD) have a considerably higher risk of death
due to cardiovascular causes. Using an iTRAQ MS/MS approach, we investigated the
alterations in plasma protein accumulation in patients with CKD and classical
cardiovascular disease (CVD) without CKD. The proteomic analysis led to the
identification of 130 differentially expressed proteins among CVD and CKD patients
and healthy volunteers. Bioinformatics analysis revealed that 29 differentially
expressed proteins were involved in lipid metabolism and atherosclerosis, 20 of
which were apolipoproteins and constituents of high-density lipoprotein (HDL) and
low-density lipoprotein (LDL). Although dyslipidemia is common in CKD patients, we
found that significant changes in apolipoproteins were not strictly associated with
changes in plasma lipid levels. A lack of correlation between apoB and LDL
concentration and an inverse relationship of some proteins with the HDL level were
revealed. An increased level of apolipoprotein AIV, adiponectin, or apolipoprotein
C, despite their anti-atherogenic properties, was not associated with a decrease in
cardiovascular event risk in CKD patients. The presence of the distinctive pattern
of apolipoproteins demonstrated in this study may suggest that lipid abnormalities
in CKD are characterized by more qualitative abnormalities and may be related to HDL
function rather than HDL deficiency.