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Kidney Week

Abstract: SA-PO190

HDL Subclasses Alter with CKD Progression and Are Associated with ABI and Klotho Level in CKD-Stage-Specific Manner

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Kanda, Eiichiro, Tokyo Kyosai Hospital, Meguro, TOKYO, Japan
  • Maeda, Yoshitaka, JA Toride Medical Center, Ibaraki, Japan
Background

Atherosclerosis is a complication of chronic kidney disease (CKD). Lipoprotein subclasses consist of a continuous spectrum of particles of different sizes and densities, and high-density lipoproteins (HDLs) are grouped into various subclasses (Table 1). We investigated the roles of lipoprotein subclasses in atherosclerosis and CKD-mineral and bone disorder.

Methods

Seventy one CKD patients (male, 70.4%; diabetic nephropathy, 23.9%) were enrolled in this prospective cohort study in Japan. The proportion of cholesterol level to total cholesterol level and the lipoprotein particle number in 20 lipoprotein fractions were measured by a newly developed method of high-performance gel permeation chromatography (HGPC).

Results

The average age (SD) was 75.0 (11.1) years and the estimated glomerular filtration rate (eGFR) was 17.2 (8.3) ml/min/1.73m2. Although no statistically significant difference in cholesterol levels in lipoproteins or triglyceride levels between CKD stages 4 and 5 was shown by HGPC, the method showed that the lipoprotein particle number in small HDLs was higher in Stage 4 than in Stage 5 (p=0.002). Multivariate regression analysis adjusted for baseline characteristics showed that the cholesterol proportion in very small HDLs was negatively associated with eGFR change rate [fraction (F) 19 β=-17.63, p=0.036] and was associated with ABI [F19 β= 0.047, p=0.047] in Stage 4. Moreover, serum soluble α-Klotho level was associated with the number of very small HDL particles [F19 β=0.00026, p=0.012; F20 β=0.00041, p=0.036] in Stage 5.

Conclusion

This study showed that HDL subclasses alter with CKD progression and are associated with ABI and Klotho level in a CKD-stage-specific manner.

Definitions of classes and subclasses of lipoproteins
FractionF1-2F3-5F6F7F8F9F10F11-13F14-15F16F17F18F19-20
SubclassCMLarge VLDLMedium VLDLSmall VLDLLarge LDLMedium LDLSmall LDLVery small LDLVery large HDLLarge HDLMedium HDLSmall HDLVery small HDL