a Vascular and Renal Translational Research Group , Institute for Biomedical Research of Lleida (IRBLleida), REDinREN del ISCIII , Lleida , Spain.
b Unitat de Medicina Vascular i Metabolisme , Sant Joan University Hospital, IISPV, CIBERDEM, Universitat Rovira I Virgili , Reus , Spain.
Expert Opin Ther Targets. 2017 Oct;21(10):967-976. doi: 10.1080/14728222.2017.1369961. Epub 2017 Aug 28.
Chronic kidney disease (CKD) is a world-wide health concern associated with a significantly higher cardiovascular morbidity and mortality. One of the principal cardiovascular risk factors is the lipid profile. CKD patients have a more frequent and progressive atheromatous disease that cannot be explained by the classical lipid parameters used in the daily clinical practice. Areas covered: The current review summarizes prevailing knowledge on the role of lipids in atheromathosis in CKD patients, including an overview of lipoprotein metabolism highlighting the CKD-induced alterations. Moreover, to obtain information beyond traditional lipid parameters, new state-of-the-art technologies such as lipoprotein subfraction profiling and lipidomics are also reviewed. Finally, we analyse the potential of new lipoprotein subclasses as therapeutic targets in CKD. Expert opinion: The CKD-induced lipid profile has specific features distinct from the general population. Besides quantitative alterations, renal patients have a plethora of qualitative lipid alterations that cannot be detected by routine determinations and are responsible for the excess of cardiovascular risk. New parameters, such as lipoprotein particle number and size, together with new biomarkers obtained by lipidomics will personalize the management of these patients. Therefore, nephrologists need to be aware of new insights into lipoprotein metabolism to improve cardiovascular risk assessment.
慢性肾脏病（CKD）是一个全球性的健康问题，与心血管发病率和死亡率显著升高有关。主要心血管危险因素之一是血脂谱。CKD 患者的动脉粥样硬化疾病更频繁且更具侵袭性，这不能用日常临床实践中使用的经典脂质参数来解释。
本综述总结了目前关于脂质在 CKD 患者动脉粥样硬化中的作用的知识，包括脂蛋白代谢概述，重点介绍了 CKD 引起的改变。此外，为了获得超越传统脂质参数的信息，还综述了新的最先进技术，如脂蛋白亚组分分析和脂质组学。最后，我们分析了新的脂蛋白亚型作为 CKD 治疗靶点的潜力。
CKD 引起的脂质谱具有与一般人群不同的特定特征。除了定量改变外，肾患者还有大量的定性脂质改变，这些改变无法通过常规检测检测到，是导致心血管风险增加的原因。脂蛋白颗粒数和大小等新参数以及通过脂质组学获得的新生物标志物将使这些患者的管理实现个体化。因此，肾病学家需要了解脂蛋白代谢的新见解，以改善心血管风险评估。
