F. Tornero et al., Apolipoproteins C-II and C-III abnormalities in hyperlipidemic and normolipidemic patients with chronic renal failure, NEFROLOGIA, 20(1), 2000, pp. 47-53
The high incidence of arteriosclerotic disease in patients with chronic ren
al failure seems to be due to certain peculiarities in their lipid metaboli
sm. These are principally a disorder in the transportation of lipoproteins
and a concomitant defect in triglyceride metabolism causing an accumulation
of triglyceride-rich-lipoproteins which predispose to atherosclerosis.
We studied the disturbances in concentration of apolipoproteins, notably Ap
o C-ll and C-lll, which modulate the activity of lipoprotein lipase (LPL),
in patients with chronic renal failure (CRF) without replacement therapy an
d in hemodialysis patients with and without hyperlipidemia. LPL hydrolyses
triglycerides in the lipoprotein-triglyceride (LPRTG) core.
The main lipid parameters were measured in 4 groups of normolipidemic and h
yperlipidemic patients with and without CRF in comparison with healthy cont
rols. We found that the lipolytic activity index (A-I/C-III) was decreased,
and Apo C-lll levels were increased, in patients with CRF and patients on
HD, including normolipidemic patients.
We conclude that high Apo C-lll levels are found in uremic patients before
starting dialysis and do not change during dialysis treatment. This increas
e could be one of the initial causes of impaired triglyceride catabolism an
d LPRTG accumulation even in normolipidemic patients with CRF and may be on
e explanation of the high mortality from cardiovascular disease in these pa
tients.