期刊
JOURNAL OF LIPID RESEARCH
卷 62, 期 -, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.jlr.2021.100024
关键词
cardiovascular disease; cholesterol; eicosanoids; HDL function; paraoxonase; renal disease
资金
- Foundation for Anesthesia Education and Research [MRTG-CT-08-15-17]
- NIH [T32 GM108554, K23 GM134482, UL1 TR000445, K23 GM102676, R01 GM112871, P01 HL116263]
- Vanderbilt University Medical Center Department of Anesthesiology
The study found that higher preoperative HDL-P concentration is associated with less AKI, indicating lower oxidative damage. Changes in HDL-P concentrations during surgery are also associated with AKI.
Oxidative stress promotes acute kidney injury (AKI). Higher HDL cholesterol concentrations are associated with less AKI. To test the hypothesis that HDL antioxidant activity is associated with AKI after cardiac surgery, we quantified HDL particle (HDL-P) size and number, paraoxonase-1 (PON-1) activity, and isofuran concentrations in 75 patients who developed AKI and 75 matched control patients. Higher preoperative HDL-P was associated with less AKI (OR: 0.80; 95% CI, 0.71-0.91; P = 0.001), higher PON-1 activity ( P < 0.001), and lower plasma concentrations of isofurans immediately after surgery (P = 0.02). Similarly, higher preoperative small HDL-P was associated with less AKI, higher PON-1 activity, and lower isofuran concentrations. Higher intraoperative particle losses were associated with less AKI (OR: 0.79; 95% CI 0.67-0.93; P = 0.005), and with decreased postoperative isofuran concentrations (P = 0.04) . Additionally, higher preoperative small HDL-P and increased intraoperative small particle loss were associated with improved long-term renal function (P = 0.003, 0.01, respectively). In conclusion, a higher preoperative concentration of HDL-P, particularly small particles, is associated with lower oxidative damage and less AKI. Perioperative changes in HDL-P concentrations are also associated with AKI. Small HDL-P may represent a novel modifiable risk factor for AKI.
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