Nephrotic origin hyperlipidemia, relative reduction of vitamin E level andsubsequent oxidative stress may promote atherosclerosis

Background. The relation between nephrotic syndrome and atherosclerosis has not yet been fully clarified, although the high levels of low-density lipo protein cholesterol usually found in this syndrome may give rise to atheros clerosis. This study was intended to test the disturbances of antioxidant/o xidant status in children with nephrotic syndrome (NS). Methods: 8 children in the active stage (AS) of NS, 7 children during the remission stage (REM ) of NS, and 14 control subjects (CTRL) were enrolled into the study. The l evels of plasma total cholesterol (TC), HDL-cholesterol (HDL-chol), LDL-cho lesterol (LDL-chol), triglycerides (TG), vitamin E and 7-ketocholesterol (7 KCH) before and after plasma saponification were measured. Results: A signi ficant increase in the concentrations of TC, LDL-chol, vitamin E and total 7KCH in AS patients have been found. These patients had also a lower vitami n E/LDL-chol ratio. These changes have not been observed in the remission s tage of nephrotic syndrome. Higher amounts of electronegatively charged(oxi dized) LDL particles as well as different oxysterols in AS patients have al so been demonstrated. Conclusion: The study revealed significant disturbanc es in oxidant status during NS leading to plasma accumulation of oxidized L DL and cholesterol oxidation products that exert cytotoxicity and are known to induce atherosclerosis. We suggest that this may constitute an importan t link between nephrotic syndrome and atherosclerosis. Copyright (C) 2001 S . Karger AG, Basel.