[Changes in serum lipoproteins in kidney diseases].

Secondary hyperlipoproteinemias frequently occur in patients with conservatively treated chronic uremia, under hemodialysis, after renal transplantation and notably in patients with the nephrotic syndrome. In chronic uremia patients conservatively treated or under hemodialysis, hypertriglyceridemia (type IV-pattern) is predominant whereas after renal transplantation and in the nephrotic syndrome hypercholesterolemia (type II-pattern) is more frequent. With the exception of hyperlipoproteinemia in the nephrotic syndrome, these hyperlipoproteinemias are associated with markedly reduced levels of the protective HDL. They therefore represent a relevant atherogenic risk. Lipoprotein disorders in chronic uremia are mainly due to disturbed catabolism of triglyceride-rich lipoproteins; treatment with corticosteroids may be the major underlying pathogenic mechanism of hyperlipoproteinemia after renal transplantation, whereas in the nephrotic syndrome increased hepatic lipoprotein production is observed.