Dialysis Modalities and HDL Composition and Function

• Published in: Journal of the American Society of Nephrology 2015-09, Vol.26 (9), p.2267-2276
• Main Authors: Holzer, Michael, Schilcher, Gernot, Curcic, Sanja, Trieb, Markus, Ljubojevic, Senka, Stojakovic, Tatjana, Scharnagl, Hubert, Kopecky, Chantal M, Rosenkranz, Alexander R, Heinemann, Akos, Marsche, Gunther
• Format: Article
• Language: English
• Subjects: 1-Alkyl-2-acetylglycerophosphocholine Esterase - metabolism; Aged; Aryldialkylphosphatase - metabolism; Case-Control Studies; Cells, Cultured; Cholesterol - metabolism; Cholesterol Ester Transfer Proteins - blood; Clinical Research; Female; Humans; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - enzymology; Kidney Failure, Chronic - therapy; Lipopolysaccharides - pharmacology; Lipoprotein Lipase - blood; Lipoproteins, HDL - blood; Lipoproteins, HDL - chemistry; Lipoproteins, HDL - pharmacology; Macrophages - metabolism; Male; Middle Aged; Monocytes - drug effects; Monocytes - metabolism; NF-kappa B - metabolism; Peritoneal Dialysis; Phosphatidylcholine-Sterol O-Acyltransferase - blood; Phospholipid Transfer Proteins - blood; Renal Dialysis - methods; Triglycerides - blood
• ISSN: 1046-6673; 1533-3450
• DOI: 10.1681/ASN.2014030309

Lipid abnormalities may have an effect on clinical outcomes of patients on dialysis. Recent studies have indicated that HDL dysfunction is a hallmark of ESRD. In this study, we compared HDL composition and metrics of HDL functionality in patients undergoing hemodialysis (HD) or peritoneal dialysis (PD) with those in healthy controls. We detected a marked suppression of several metrics of HDL functionality in patients on HD or PD. Compositional analysis revealed that HDL from both dialysis groups shifted toward a more proinflammatory phenotype with profound alterations in the lipid moiety and protein composition. With regard to function, cholesterol efflux and anti-inflammatory and antiapoptotic functions seemed to be more severely suppressed in patients on HD, whereas HDL-associated paraoxonase activity was lowest in patients on PD. Quantification of enzyme activities involved in HDL metabolism suggested that HDL particle maturation and remodeling are altered in patients on HD or PD. In summary, our study provides mechanistic insights into the formation of dysfunctional HDL in patients with ESRD who are on HD or PD.