High density lipoprotein cholesterol levels are an independent predictor of the progression of chronic kidney disease

A. Baragetti, G. D. Norata, C. Sarcina, F. Rastelli, L. Grigore, K. Garlaschelli, P. Uboldi, I. Baragetti, C. Pozzi, A. L. Catapano

Research output: Contribution to journalArticle

Abstract

Objectives: Patients with chronic kidney disease (CKD) often present with reduced plasma HDL cholesterol (HDL-C) levels. Whether this reduction in an epiphenomenon or is involved in disease progression is unclear. The aim of this study was to investigate the relation between HDL-C levels/function and CKD progression in patients with different degrees of disease. Design: A total of 176 patients with CKD [glomerular filtration rate (GFR) 50.3 ± 29.1 mL min-1] were recruited and followed for up to 84 months. Lipid profile, metabolic status and kidney function were evaluated at predetermined times. Age-matched control subjects were selected from the PLIC study (n = 453). Scavenger receptor class B member 1 (SR-BI) and ATP-binding cassette transporter A1 (ABCA-1)-dependent efflux of cholesterol were measured in CKD patients and in age-matched control subjects. Results: Low HDL-C levels, diabetes and hypertension were associated with reduced GFR. At follow-up, low HDL-C levels were associated with earlier entry in dialysis or doubling of the plasma creatinine level (P = 0.017); HDL-C levels were the only lipid parameter that affected the progression of CKD (hazard ratio 0.951, 95% confidence interval 0.917-0.986, P = 0.007), independently of the presence of diabetes. Only SR-BI-mediated serum cholesterol efflux was significantly reduced in the group of CKD patients with low HDL-C levels compared to the control group. Conclusions: CKD patients with low levels of plasma HDL-C have a poor prognosis. HDL functionality is also impaired in renal dysfunction. These data support the relevance of HDL in influencing CKD progression.

Original languageEnglish
Pages (from-to)252-262
Number of pages11
JournalJournal of Internal Medicine
Volume274
Issue number3
DOIs
Publication statusPublished - Sep 2013

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Chronic Renal Insufficiency
HDL Cholesterol
Disease Progression
Glomerular Filtration Rate
Class B Scavenger Receptors
Cholesterol
Kidney
Lipids
ATP-Binding Cassette Transporters
Metabolome
Dialysis
Creatinine
Confidence Intervals
Hypertension
Control Groups
Serum

Keywords

  • ABCA-1
  • Cholesterol efflux
  • Chronic kidney disease
  • Dialysis
  • HDL
  • SR-BI

ASJC Scopus subject areas

  • Internal Medicine

Cite this

High density lipoprotein cholesterol levels are an independent predictor of the progression of chronic kidney disease. / Baragetti, A.; Norata, G. D.; Sarcina, C.; Rastelli, F.; Grigore, L.; Garlaschelli, K.; Uboldi, P.; Baragetti, I.; Pozzi, C.; Catapano, A. L.

In: Journal of Internal Medicine, Vol. 274, No. 3, 09.2013, p. 252-262.

Research output: Contribution to journalArticle

Baragetti, A, Norata, GD, Sarcina, C, Rastelli, F, Grigore, L, Garlaschelli, K, Uboldi, P, Baragetti, I, Pozzi, C & Catapano, AL 2013, 'High density lipoprotein cholesterol levels are an independent predictor of the progression of chronic kidney disease', Journal of Internal Medicine, vol. 274, no. 3, pp. 252-262. https://doi.org/10.1111/joim.12081
Baragetti, A. ; Norata, G. D. ; Sarcina, C. ; Rastelli, F. ; Grigore, L. ; Garlaschelli, K. ; Uboldi, P. ; Baragetti, I. ; Pozzi, C. ; Catapano, A. L. / High density lipoprotein cholesterol levels are an independent predictor of the progression of chronic kidney disease. In: Journal of Internal Medicine. 2013 ; Vol. 274, No. 3. pp. 252-262.
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abstract = "Objectives: Patients with chronic kidney disease (CKD) often present with reduced plasma HDL cholesterol (HDL-C) levels. Whether this reduction in an epiphenomenon or is involved in disease progression is unclear. The aim of this study was to investigate the relation between HDL-C levels/function and CKD progression in patients with different degrees of disease. Design: A total of 176 patients with CKD [glomerular filtration rate (GFR) 50.3 ± 29.1 mL min-1] were recruited and followed for up to 84 months. Lipid profile, metabolic status and kidney function were evaluated at predetermined times. Age-matched control subjects were selected from the PLIC study (n = 453). Scavenger receptor class B member 1 (SR-BI) and ATP-binding cassette transporter A1 (ABCA-1)-dependent efflux of cholesterol were measured in CKD patients and in age-matched control subjects. Results: Low HDL-C levels, diabetes and hypertension were associated with reduced GFR. At follow-up, low HDL-C levels were associated with earlier entry in dialysis or doubling of the plasma creatinine level (P = 0.017); HDL-C levels were the only lipid parameter that affected the progression of CKD (hazard ratio 0.951, 95{\%} confidence interval 0.917-0.986, P = 0.007), independently of the presence of diabetes. Only SR-BI-mediated serum cholesterol efflux was significantly reduced in the group of CKD patients with low HDL-C levels compared to the control group. Conclusions: CKD patients with low levels of plasma HDL-C have a poor prognosis. HDL functionality is also impaired in renal dysfunction. These data support the relevance of HDL in influencing CKD progression.",
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AU - Baragetti, A.

AU - Norata, G. D.

AU - Sarcina, C.

AU - Rastelli, F.

AU - Grigore, L.

AU - Garlaschelli, K.

AU - Uboldi, P.

AU - Baragetti, I.

AU - Pozzi, C.

AU - Catapano, A. L.

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N2 - Objectives: Patients with chronic kidney disease (CKD) often present with reduced plasma HDL cholesterol (HDL-C) levels. Whether this reduction in an epiphenomenon or is involved in disease progression is unclear. The aim of this study was to investigate the relation between HDL-C levels/function and CKD progression in patients with different degrees of disease. Design: A total of 176 patients with CKD [glomerular filtration rate (GFR) 50.3 ± 29.1 mL min-1] were recruited and followed for up to 84 months. Lipid profile, metabolic status and kidney function were evaluated at predetermined times. Age-matched control subjects were selected from the PLIC study (n = 453). Scavenger receptor class B member 1 (SR-BI) and ATP-binding cassette transporter A1 (ABCA-1)-dependent efflux of cholesterol were measured in CKD patients and in age-matched control subjects. Results: Low HDL-C levels, diabetes and hypertension were associated with reduced GFR. At follow-up, low HDL-C levels were associated with earlier entry in dialysis or doubling of the plasma creatinine level (P = 0.017); HDL-C levels were the only lipid parameter that affected the progression of CKD (hazard ratio 0.951, 95% confidence interval 0.917-0.986, P = 0.007), independently of the presence of diabetes. Only SR-BI-mediated serum cholesterol efflux was significantly reduced in the group of CKD patients with low HDL-C levels compared to the control group. Conclusions: CKD patients with low levels of plasma HDL-C have a poor prognosis. HDL functionality is also impaired in renal dysfunction. These data support the relevance of HDL in influencing CKD progression.

AB - Objectives: Patients with chronic kidney disease (CKD) often present with reduced plasma HDL cholesterol (HDL-C) levels. Whether this reduction in an epiphenomenon or is involved in disease progression is unclear. The aim of this study was to investigate the relation between HDL-C levels/function and CKD progression in patients with different degrees of disease. Design: A total of 176 patients with CKD [glomerular filtration rate (GFR) 50.3 ± 29.1 mL min-1] were recruited and followed for up to 84 months. Lipid profile, metabolic status and kidney function were evaluated at predetermined times. Age-matched control subjects were selected from the PLIC study (n = 453). Scavenger receptor class B member 1 (SR-BI) and ATP-binding cassette transporter A1 (ABCA-1)-dependent efflux of cholesterol were measured in CKD patients and in age-matched control subjects. Results: Low HDL-C levels, diabetes and hypertension were associated with reduced GFR. At follow-up, low HDL-C levels were associated with earlier entry in dialysis or doubling of the plasma creatinine level (P = 0.017); HDL-C levels were the only lipid parameter that affected the progression of CKD (hazard ratio 0.951, 95% confidence interval 0.917-0.986, P = 0.007), independently of the presence of diabetes. Only SR-BI-mediated serum cholesterol efflux was significantly reduced in the group of CKD patients with low HDL-C levels compared to the control group. Conclusions: CKD patients with low levels of plasma HDL-C have a poor prognosis. HDL functionality is also impaired in renal dysfunction. These data support the relevance of HDL in influencing CKD progression.

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