Nephrology Section, Veterans Affairs Medical Center, Long Beach, 5901 E 7th St, Long Beach, CA 90822.
University of California, Irvine, 333 City Blvd West, Orange, CA 92868,
Front Biosci (Landmark Ed). 2018 Jan 1;23(1):146-161. doi: 10.2741/4585.
Chronic kidney disease (CKD) is a progressive condition marked by protracted kidney damage which over time can lead to end stage renal disease (ESRD). CKD can be categorized into different stages based on the extent of renal damage and degree of renal dysfunction with ESRD requiring renal replacement therapy considered the final stage. It is important to note that CKD in all of its forms is associated with accelerated atherosclerosis, cardiovascular (CV) disease and poor CV outcomes. While a number of factors contribute to the high risk of CV mortality in this patient population, dyslipidemia is considered to be a key player in the pathogenesis of CV disease in CKD. Molecular mechanisms responsible for CKD-associated lipid disorders are unique and greatly influenced by the stage of renal disease, presence and degree of proteinuria and in patients with ESRD, modality of renal replacement therapy. This article provides a detailed overview of the molecular mechanisms which cause dyslipidemia and the nature of lipid disorders associated with CKD and ESRD.
慢性肾脏病（CKD）是一种进行性疾病，其特征为肾脏损伤迁延不愈，随着时间的推移可导致终末期肾病（ESRD）。CKD 可以根据肾脏损伤的程度和肾功能障碍的程度分为不同的阶段，ESRD 需要肾脏替代治疗被认为是终末期。需要注意的是，CKD 的所有形式都与动脉粥样硬化加速、心血管（CV）疾病和不良 CV 结局相关。虽然有许多因素导致该患者群体的 CV 死亡率风险较高，但血脂异常被认为是 CKD 患者 CV 疾病发病机制中的关键因素。导致 CKD 相关脂质紊乱的分子机制是独特的，并且受肾脏疾病的阶段、蛋白尿的存在和程度以及 ESRD 患者的肾脏替代治疗方式的影响很大。本文详细介绍了导致血脂异常的分子机制，以及与 CKD 和 ESRD 相关的脂质紊乱的性质。
