Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Clin Exp Nephrol. 2014 Apr;18(2):251-4. doi: 10.1007/s10157-013-0857-x. Epub 2013 Sep 10.
Traditional risk factors do not account for increased cardiovascular disease in patients with chronic kidney disease (CKD), particularly individuals whose CKD has progressed to end-stage kidney disease requiring dialysis. CKD patients on dialysis show little to no cardiovascular benefits from lipid-lowering therapy and thus have an exaggerated residual cardiovascular risk. High density lipoprotein (HDL) quantity and functionality may explain some of the residual risk. CKD affects the composition and disrupts the functionality of HDL, including cholesterol acceptor function and inflammatory effects. Notably, although these HDL abnormalities prevail in CKD, they do not track together and thereby support the idea of separate and distinct mechanistic pathways for each critical function of HDL. Targeting individual perturbations in HDL function represents a novel approach to therapy in this population.
传统的风险因素并不能解释慢性肾脏病（CKD）患者心血管疾病的增加，特别是那些 CKD 已进展到需要透析的终末期肾病的患者。接受透析的 CKD 患者从降脂治疗中几乎没有获得心血管益处，因此存在明显的残余心血管风险。高密度脂蛋白（HDL）的数量和功能可能解释了一些残余风险。CKD 会影响 HDL 的组成并破坏其功能，包括胆固醇接受功能和炎症作用。值得注意的是，尽管这些 HDL 异常在 CKD 中普遍存在，但它们并没有一起出现，从而支持了每个 HDL 关键功能存在独立且不同的机制途径的观点。针对 HDL 功能的个体异常进行靶向治疗代表了该人群治疗的一种新方法。
