Increased high density lipoprotein cholesterol in adult nephrotic syndrome in Nigeria.

Forty-eight adult subjects consisting of 28 patients with nephrotic syndrome and 20 control subjects were studied. The plasma levels of high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) cholesterol were all significantly elevated in the patients with nephrotic syndrome. The elevations in plasma total cholesterol and triglyceride concentrations and the ratio of LDL cholesterol/HDL cholesterol were also significant. On the other hand, there was a significant reduction in the ratio of HDL cholesterol to total cholesterol in the nephrotics. Our results suggest altered lipid and lipoprotein metabolism in adult nephrotic syndrome. The significant increase in low density lipoprotein cholesterol and the reduction in the ratio of HDL cholesterol to total cholesterol, despite the high HDL cholesterol, probably suggests an increased risk for developing coronary heart disease in Nigerian adults suffering from nephrotic syndrome. It is therefore suggested that patient-management strategies for nephrotic syndrome should include lowering of cholesterol by dietary and/or pharmacological therapies.