CHOLESTEROL PRECURSOR CONCENTRATION IN PLASMA FROM PATIENTS WITH CHRONIC-RENAL-FAILURE OR KIDNEY GRAFTS

Plasma lathosterol concentration which is an index of cholesterol synt hesis rate was measured in 36 patients with chronic renal failure (CRF ) including 13 who were dialysis independent, 12 receiving hemodialysi s and 11 on continuous ambulatory peritoneal dialysis (CAPD), 17 renal transplant recipients and 27 healthy control subjects. Concentrations of plasma lathosterol were significantly (ANOVA p = 0.03) lower in al l categories of renal patients excepting those treated by CAPD, compar ed with control values. In normolipidemic subjects (cholesterol less t han or equal to 6.50 mmol/l and triglycerides less than or equal to 2. 0 mmol/l) plasma lathosterol levels in hemodialysis patients and renal transplant recipients were still significantly (ANOVA p = 0.02) lower than control values. In transplant recipients, the plasma lathosterol /cholesterol ratio was significantly (p = 0.02) lower in those treated with azathioprine and prednisone compared with those treated with the se drugs and cyclosporin. Significant (p <0.001) positive correlations were recorded between plasma lathosterol concentration and plasma lev els of apolipoprotein B (apoB) and very low density lipoprotein (VLDL) lipids in the renal patients. These data suggest that the rate of cho lesterol. synthesis may be low in undialysed and hemodialysed patients with CRF and in renal transplant recipients, particularly those treat ed with double therapy, and may be linked to the metabolism of apoB an d VLDL.