Journal
TOXINS
Volume 14, Issue 6, Pages -Publisher
MDPI
DOI: 10.3390/toxins14060412
Keywords
cholesterol; lipids; lipoproteins; renal disease; triglycerides; uremic retention solutes; uremic toxins
Categories
Funding
- CaReSyAn Horizon 2020 [764474]
- Strategic Research Program in Diabetes at Karolinska Institutet (Swedish Research Council) [2009-1068]
- Heart and Lung Foundation [20160384]
- Njurfonden
- Swedish Research Council [Vetenskapsradet 2018-00932 GOING-FWD]
- Novo Nordisk postdoctoral fellowship
- Karolinska Institutet
- Karolinska Institutet Research Foundation
- Stiftelsen Stig och Gunborg Westman
- EFSD Mentorship Programme by AstraZeneca
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Patients with kidney failure have a high incidence of cardiovascular disease, partly due to insufficient clearance of uremic toxins. A study found significant inverse associations between lipid profile and different uremic toxins, highlighting the complexity of the uremic milieu.
Patients with kidney failure (KF) have a high incidence of cardiovascular (CV) disease, partly driven by insufficient clearance of uremic toxins. Recent investigations have questioned the accepted effects of adverse lipid profile and CV risk in uremic patients. Therefore, we related a panel of uremic toxins previously associated with CV morbidity/mortality to a full lipid profile in a large, tri-national, cross-sectional cohort. Total, high-density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL), and remnant cholesterol, as well as triglyceride, levels were associated with five uremic toxins in a cohort of 611 adult KF patients with adjustment for clinically relevant covariates and other patient-level variables. Univariate analyses revealed negative correlations of total, non-HDL, and LDL cholesterol with all investigated uremic toxins. Multivariate linear regression analyses confirmed independent, negative associations of phenylacetylglutamine with total, non-HDL, and LDL cholesterol, while indole-3 acetic acid associated with non-HDL and LDL cholesterol. Furthermore, trimethylamine-N-Oxide was independently and negatively associated with non-HDL cholesterol. Sensitivity analyses largely confirmed findings in the entire cohort. In conclusion, significant inverse associations between lipid profile and distinct uremic toxins in KF highlight the complexity of the uremic milieu, suggesting that not all uremic toxin interactions with conventional CV risk markers may be pathogenic.
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