ROLE OF LIPOPROTEINS IN PROGRESSIVE RENAL-DISEASE

Renal diseases are often associated with hyperlipoproteinemia and dysl ipoproteinemia. Total serum cholesterol and triglycerides are increase d in nephrotic syndrome regardless of etiology. Approximately 40 to 50 % of patients with renal insufficiency requiring hemodialysis show hyp ertriglyceridemia and dyslipoproteinemia. During chronic hemodialysis, high doses of unfractionated heparin deplete post-heparin lipolytic a ctivity and aggravate dyslipoproteinemia. Hypercholesterolemia and hyp erlipoproteinemia are often encountered in patients taking glucocortic oids and cyclosporin A after renal transplantation. Observations in ex perimental animals and in patients with genetically determined and acq uired hyperlipidemias suggest that lipids can damage the kidney and le ad to glomerulosclerosis. In vitro cell-culture studies of human glome rular cells have been useful in providing information on lipid-induced glomerular damage. Thus, there are strong indications that lipoprotei ns may play a critical role in the development of mesangial cell damag e and progressive renal disease. Therapeutic measures that reduce and correct dyslipoproteinemia in renal disease may have long-term benefic ial effects on the amelioration of renal disease.