Barbagallo Carlo Maria, Cefalù Angelo Baldassare, Giammanco Antonina, Noto Davide, Caldarella Rosalia, Ciaccio Marcello, Averna Maurizio Rocco, Nardi Emilio
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties-University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy.
Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), Section of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, 90127 Palermo, Italy.
Life (Basel). 2021 Apr 5;11(4):315. doi: 10.3390/life11040315.
Chronic kidney disease (CKD) is one of the most important risk factors for cardiovascular disease (CVD). Despite the kidney having no direct implications for lipoproteins metabolism, advanced CKD dyslipidemia is usually present in patients with CKD, and the frequent lipid and lipoprotein alterations occurring in these patients play a role of primary importance in the development of CVD. Although hypertriglyceridemia is the main disorder, a number of lipoprotein abnormalities occur in these patients. Different enzymes pathways and proteins involved in lipoprotein metabolism are impaired in CKD. In addition, treatment of uremia may modify the expression of lipoprotein pattern as well as determine acute changes. In renal transplantation recipients, the main lipid alteration is hypercholesterolemia, while hypertriglyceridemia is less pronounced. In this review we have analyzed lipid and lipoprotein disturbances in CKD and also their relationship with progression of renal disease. Hypolipidemic treatments may also change the natural history of CVD in CKD patients and may represent important strategies in the management of CKD patients.
慢性肾脏病（CKD）是心血管疾病（CVD）最重要的危险因素之一。尽管肾脏对脂蛋白代谢没有直接影响，但晚期CKD患者通常存在血脂异常，这些患者中频繁出现的脂质和脂蛋白改变在CVD的发生发展中起着至关重要的作用。虽然高甘油三酯血症是主要病症，但这些患者还会出现多种脂蛋白异常。CKD患者中参与脂蛋白代谢的不同酶途径和蛋白质均受到损害。此外，尿毒症的治疗可能会改变脂蛋白模式的表达并导致急性变化。在肾移植受者中，主要的脂质改变是高胆固醇血症，而高甘油三酯血症则不太明显。在本综述中，我们分析了CKD患者的脂质和脂蛋白紊乱情况以及它们与肾脏疾病进展的关系。降血脂治疗也可能改变CKD患者CVD的自然病程，并且可能是CKD患者管理中的重要策略。
