Mordasini R, Riesen W
Schweiz Med Wochenschr. 1982 Sep 25;112(39):1335-40.
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.
继发性高脂血症常见于保守治疗的慢性尿毒症患者、血液透析患者、肾移植后患者，尤其是肾病综合征患者。在保守治疗或接受血液透析的慢性尿毒症患者中，高甘油三酯血症（IV型）占主导，而肾移植后和肾病综合征患者中高胆固醇血症（II型）更为常见。除肾病综合征中的高脂蛋白血症外，这些高脂血症都伴有具有保护作用的高密度脂蛋白水平显著降低。因此，它们代表了一种相关的动脉粥样硬化风险。慢性尿毒症中的脂蛋白紊乱主要是由于富含甘油三酯的脂蛋白分解代谢紊乱；肾移植后高脂血症的主要潜在致病机制可能是使用皮质类固醇治疗，而在肾病综合征中则观察到肝脏脂蛋白生成增加。
