Low-density lipoprotein clearance in patients with chronic renal failure.

BACKGROUND: Chronic renal failure increases the risk of atherosclerosis. The clearance of low-density lipoprotein (LDL), a major risk factor for atherosclerosis, has been reported as being disturbed in dialysis patients. We studied LDL metabolism in non-dialyzed patients with chronic kidney disease (CKD).
METHODS: LDL clearance was studied with a radiotracer method in 57 CKD patients and 10 healthy controls.
RESULTS: In the CKD patients, the fractional catabolic rate of LDL apo B (LDL FCR), an indicator of LDL clearance from plasma, ranged from 0.13 to 0.56 pools/day with a mean value of 0.34 pools/day being comparable to that of the control subjects. In the renal patients, LDL FCR correlated significantly with estimated glomerular filtration rate (eGFR) (r = 0.340, P = 0.010) and this association remained significant after the adjustment with age, body mass index, gender, presence of diabetes and LDL cholesterol concentration (P = 0.004). In CKD patients with eGFR <15 mL/min/1.73 m(2) the mean LDL FCR was significantly reduced when compared to that of CKD patients with eGFR >30 mL/min/1.73 m(2) (P = 0.005). LDL apo B production rate was not associated with renal function or different between renal patients and control subjects.
CONCLUSIONS: The clearance of LDL seems to be related to the severity of renal impairment, but a remarkable reduction in LDL catabolism can be observed only in patients with advanced renal failure.