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A Retrospective Study on the Influence of Apolipoprotein E and Serum Lipids in Progressive Renal Failure

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Background: Progression of renal failure is associated with altered lipoprotein metabolism. Apolipoprotein E polymorphism is an important genetic marker for dyslipidemia. The main purpose of this retrospective study was to examine the influence of apolipoprotein E polymorphism and serum lipids level on the progression rate in a group of patients with kidney diseases of diverse etiology. Methods: Progression rate, with regard to apolipoprotein E polymorphism and initial serum creatinine value, median (162 μmol/l), was determined by reviewing the charts of 385 patients on renal replacement therapy with a median follow-up time of 4.85 years. Results: Progression rate was negatively correlated to serum cholesterol in the group with type 2 diabetes (p= 0.001). In addition, the urine albumin excretion rate (UAER) was higher in type 2 diabetics carrying the ɛ2 allele (2.1 g/l) as compared to non-ɛ2 allele carriers (1.2 g/l) (p=0.009). Although serum cholesterol in patients with autosomal dominant polycystic kidney disease (ADPKD) carrying the apolipoprotein ɛ4 allele was 5.87 ± 1.0 mmol/l, which was significantly higher compared to non-ɛ4 carriers, 4.97 ± 1.1 mmol/l (p=0.026), progression rate was similar in the two groups, 4.4 ± 0.8 μmol/l/year. An increase in the relative frequency of the apolipoprotein ɛ4 allele was found in patients with ADPKD (0.29), as compared to (0.16) in the rest of the diagnostic groups (p=0.0023). In addition, in the whole study population a positive correlation was found between progression rate and underlying disease (p < 0.005), UAER (p < 0.005) and blood pressure (p < 0.005). Conclusions: The results of the present study indicate that the decline of renal function in patients with diabetes type 2 may not be associated with levels of plasma cholesterol, but with triglyceride lipoproteins, considered remnant lipoproteins. Any association between cholesterol and apolipoprotein ɛ4 allele with progression in ADPKD may not necessarily be straightforward since this disease is influenced by other genetic and unidentified factors.

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  1. 1.

    El Nahas AM. Mechanisms of experimental and clinical renal scarring. In: Davison AM, Cameron JS, Crünfeld JP, Kerr DNS, Ritz E, Winearls CG, eds. Oxford Textbook of Clinical Nephrology, Vol. 3. 1998: 1749–1788

  2. 2.

    Locatelli F, Vecchio LD, Andrulli S et al. (2000). The role of underlying nephropathy in the progression of renal disease. Kidney Int (S75): 49–55

  3. 3.

    JC Peterson S Adler JM Buckart et al. (1995) ArticleTitleBlood pressure control, proteinuria, and the progression of renal disease. The modification of diet in renal disease study Ann Intern Med 123 754–762 Occurrence Handle7574193

  4. 4.

    PO Attman O Samuelsson P. Alaupovic (1993) ArticleTitleLipoprotein metabolism in renal failure Review. Am J Kidney Dis 21 573–592

  5. 5.

    WF. Keane (1996) ArticleTitleLipids and progressive renal failure Wien Klin Wochenschr 108 IssueID14 420–442 Occurrence Handle8784983

  6. 6.

    P Jungers T Hannedouche Y Itakura et al. (1995) ArticleTitleProgression rate to end-stage renal failure in non-diabetic kidney diseases: a multivariate analysis of determinant factors Nephrol Dial Transplant 10 1353–1360 Occurrence Handle8538926

  7. 7.

    Diamond RJ. (1991). Analogous pathobiologic mechanisms in glomerulosclerosis and atherosclerosis. Kidney Int (S39): 29–34

  8. 8.

    J Davignon RE Gregg CF. Sing (1988) ArticleTitleApolipoprotein E polymorphism and atherosclerosis Arteriosclerosis 8 1–21 Occurrence Handle3277611

  9. 9.

    E Werle W Fiehn C. Hasslacher (1998) ArticleTitleApolipoprotein E polymorphism and renal function in German type 1 and type 2 diabetic patients Diabetes Care 21 994–998 Occurrence Handle9614620

  10. 10.

    M Eto K Horita A Morikawa et al. (1995) ArticleTitleIncreased frequency of apolipoprotein ɛ2 allele in non-insulin dependent diabetic (NIDDM) patients with nephropathy Clin Genet 48 288–292 Occurrence Handle8835322

  11. 11.

    H Kimura Y Suzuki F Gejyo et al. (1998) ArticleTitleApolipoprotein E4 reduces risk of diabetic nephropathy in patients with NIDDM Am J Kidney Dis 31 666–673 Occurrence Handle9531184

  12. 12.

    M Eto M Saito M Okada et al. (2002) ArticleTitleApolipoprotein E genetic polymorphism, remnant lipoproteins, and nephropathy in type 2 diabetic patients Am J Kidney Dis 40 243–251 Occurrence Handle10.1053/ajkd.2002.34502 Occurrence Handle12148096

  13. 13.

    S Lehtinen V Rantalaiho O Wirta et al. (2003) ArticleTitleApolipoprotein E gene polymorphism, hypercholesterolemia and glomerular filtration rate in type 2 diabetic subjects: a 9-year follow-up study J Biomed Sci 10 260–265 Occurrence Handle10.1159/000068712 Occurrence Handle12595762

  14. 14.

    WE Mitch M Walser GA Buffington J Lemann SuffixJr. (1976) ArticleTitleA simple method of estimating progresssion of chronic renal failure The Lancet 2 1326–1328 Occurrence Handle10.1016/S0140-6736(76)91974-7

  15. 15.

    WE Rutherford J Blondin JP Miller et al. (1977) ArticleTitleChronic progressive renal disease: rate of change of serum creatinine concentration Kidney Int 11 62–70 Occurrence Handle839654

  16. 16.

    J Hixson D. Vernier (1990) ArticleTitleRestriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI J Lipid Res 31 545–548 Occurrence Handle2341813

  17. 17.

    Keane WF. The role of lipids in renal disease: future challenges. Kidney Int 2000; (suppl 75): 27–31

  18. 18.

    F Bonnet ME. Cooper (2000) ArticleTitlePotential influence of lipids in diabetic nephropathy: insights from experimental data and clinical studies Diabetes Metab 26 254–264 Occurrence Handle11011217

  19. 19.

    TJ Orchard YF Chang RE Ferrell et al. (2002) ArticleTitleNephropathy in type 1 diabetes: a manifestation of insulin resistance and multiple genetic susceptibilities? Kidney Int 62 IssueID3 963–970 Occurrence Handle10.1046/j.1523-1755.2002.00507.x Occurrence Handle12164879

  20. 20.

    PH Groop T Elliott A Ekstrand et al. (1996) ArticleTitleMultiple lipoprotein abnormalities in type 1 diabetic patients with renal disease Diabetes 45 974–979 Occurrence Handle8666151

  21. 21.

    S Araki DK Moczulski L Hanna et al. (2000) ArticleTitleApo E polymorphisms and the development of diabetic neuropathy in type 1 diabetes-results of case-control and family based studies Diabetes 49 2190–2195 Occurrence Handle11118024

  22. 22.

    TA Chowdhury PH Dyer S Kumar et al. (1998) ArticleTitleAssociation of apolipoprotein E2 allele with diabetic nephropathy in Caucasian subjects with IDDM Diabetes 47 278–280 Occurrence Handle9519726

  23. 23.

    Soedamah- SS Muthu HM Colhoun MR Taskinen et al. (2000) ArticleTitleDifferences in HDL-cholesterol: apo A-I + apo A-II ratio and apo E phenotype with albuminuric status in type I diabetic patients Diabetologia 43 1353–1359 Occurrence Handle10.1007/s001250051538 Occurrence Handle11126402

  24. 24.

    MA Dijk van AM Kamper S Veen van et al. (2001) ArticleTitleEffect of simvastatin on renal function in autosomal dominant polycystic kidney disease Nephrol Dial Transplant 16 2152–2157 Occurrence Handle10.1093/ndt/16.11.2152 Occurrence Handle11682660

  25. 25.

    DLM Peters MH. Breuning (2001) ArticleTitleAutosomal dominant polycystic kidney disease: modification of disease progression The Lancet 358 1439–1444 Occurrence Handle10.1016/S0140-6736(01)06531-X

  26. 26.

    Gabow PA. Cystic diseases of the kidney. In: Morgan SH, Grünfeld JP, ed. Inherited Disorders of the Kidney. Oxford University Press, 1998: 132–162

  27. 27.

    EN Liberopoulos GA Miltiadous M Cariolou et al. (2004) ArticleTitleThe influence of serum apolipoprotein E concentration and polymorphism on serum lipid parameters in hemodialysis patients Am J Kidney Dis 44 300–308 Occurrence Handle15264189

  28. 28.

    S Klahr JA Breyer GJ Beck et al. (1995) ArticleTitleDietary protein restriction, blood pressure control, and the progression of polycystic kidney disease. The modification of diet in renal disease study J Am Soc Nephrol 5 2037–2047 Occurrence Handle7579052

  29. 29.

    T Hannedouche P Chauveau F Kalou et al. (1993) ArticleTitleFactors affecting progression in advanced chronic renal failure Clin Nephrol 39 312–320 Occurrence Handle8334758

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Correspondence to L. Roussos.

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Roussos, L., Ehle, P. & Florén, C. A Retrospective Study on the Influence of Apolipoprotein E and Serum Lipids in Progressive Renal Failure. Int Urol Nephrol 37, 329–334 (2005).

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  • Apolipoprotein E polymorphism
  • Lipoprotein metabolism
  • Progression rate
  • Progressive renal failure
  • Remnant lipoproteins