Changes in plasma lecithin: cholesterol acyltransferase activity, HDL(2), HDL(3) amounts and compositions in patients with chronic renal failure after different times of hemodialysis.

The aim of this study was to investigate the effect of hemodialysis duration on HDL(2) and HDL(3) compositions and lecithin:cholesterol acyltransferase (LCAT) activity in 58 patients on acetate hemodialysis using cuprophane membrane, after different periods of dialysis. Patients were divided into three groups-GI <1 year, GII 1-5 years, GIII 5-13 years of dialysis and were compared with 22 controls. Increase by 34% of triacylglycerols (TG) was noted in GI and by 36% in GII versus GI. Hypertriglyceridemia was correlated with hemodialysis duration (HD) (r=0.75, P<0.05). The LCAT activity decrease by 25% was noted in GII versus GI (P<0.05) and by 45% in GIII versus GI (P<0.01), this activity was negligible in 33% of GII and 39% of GIII. LCAT activity was negatively correlated with HD (r=-0.80, P<0.001). Hemodialysis duration did not influence HDL(3) and HDL(2) amounts, HDL(3)-phospholipids (PL), HDL(3) and HDL(2)-cholesteryl esters (CE) and HDL(2)-apolipoproteins. However, an increase by 56% in HDL(2)-PL was noted in GIII versus GI and GII (P<0.01). HDL(2)-unesterified cholesterol (UC) were 2-fold higher in GIII than GII and GI (P<0.01). HDL(2)-TG were 2.2-fold higher in GII and 2.4-fold in GIII than GI (P<0.001). HDL(3)-apolipoproteins were 1.5-fold and 1.8-fold lower in GI than GII (P<0.05) and GIII (P<0.01), respectively. An increase in HDL(3)-UC by 20% in GII and 33% in GIII versus GI (P<0.01) was noted. HDL(3)-TG increase by 66% was noted in GII and GIII versus GI (P<0.05). We conclude, that the long-term hemodialysis does not act on lipid anomalies following CRF. Alterations in HDL composition contribute to the reduced efficacy of reverse cholesterol transport, which is a risk factor for cardiovascular disease.