RENAL FUNCTION AND MARKERS OF CARDIOVASCULAR RISK, ACTA UNIVERSITATIS OULUENSIS D Medica 1056

Patients with chronic renal insufficiency (CRI), also at its early stages, have an elevated risk of\ncardiovascular disease (CVD). Many well-established risk factors of CVD co-occur in CRI, e.g.\ndyslipidemia and hypertension. The present studies investigated the association between renal\nfunction and selected CVD risk factors.\nThe fractional catabolic rate of low-density lipoprotein apolipoprotein B (LDL FCR) has\npreviously been found to be reduced in patients with severe CRI or on dialysis. This study\ninvestigated the LDL FCR in 57 patients with moderate to severe CRI and not on dialysis.\nAlthough the mean LDL FCR was comparable between the CRI patients and healthy controls,\namong the renal patients the LDL FCR was correlated with renal function, whereas it was\nsignificantly reduced only in patients with advanced CRI (estimated glomerular filtration rate \nLeptin is a protein regulating food intake and energy expenditure and it is also involved in lipid\nmetabolism. Hyperleptinaemia is a known feature of CRI patients; they are thought to be leptin\nresistant. The association between leptin and the lipoprotein profile was studied in 73 CRI patients\nwith moderate to severe CRI and not on dialysis. Leptin was associated with lipid and lipoprotein\nconcentrations in the renal patients, as in the control subjects, pointing towards a poorer\nlipoprotein profile with higher leptin levels.\nHypertensive subjects in whom nocturnal blood pressure (BP) declines by less than 10% (nondippers)\nshow more organ damage than those in whom it falls by more than 10% (dippers). Here,\nnon-dipping was found in 19% of middle-aged subjects (226 males, 234 females) evaluated with\nambulatory BP monitoring. The non-dippers had significantly lower renal function as compared\nwith the dippers, and dipping status was a significant predictor of the variation in eGFR.\nFurthermore, an increased risk of non-dipping was observed among subjects with only minor\ndecreases in renal function.\nCarotid intima-media thickness (cIMT) can be used as a surrogate marker of early\natherosclerosis. The present study investigated the association between renal function and cIMT\nin middle-aged subjects (247 males, 258 females). Renal function was independently associated\nwith cIMT among males and also among postmenopausal women. The increased cIMT was seen\nin conjunction with mild renal impairment.\nIn conclusion, the catabolism of LDL correlated with the renal function among CRI patients,\nbut it was significantly reduced only in patients with advanced CRI. Leptin concentrations\ncorrelated with the lipoprotein profile in CRI patients. Among general middle-aged subjects, even\na mild decrease in renal function was associated with derangements in BP regulation and with\nincreased carotid atherosclerosis.

ISBN-10:
978-951-42-6202-9
Kieli:
eng.
Sivumäärä:
148 s.
Tekijät:
Kastarinen Helena
Tuotekoodi 013975
20,00 €