High Density and Low Density Lipoproteins in Chronic Renal Failure Before and After Renal Transplantation

Abstract

The hyperlipoproteinemia accompanying chronic renal failure and renal transplantation was re-examined in terms of the apoprotein (apo A and apo B) moieties of the high density (HDL) and low density (LDL) lipoproteins. Hypertriglyceridemia is prevalent in chronic uremia and is not corrected by hemodialysis or renal transplantation. Hypercholesterolemia is characteristic only of renal allograft recipients. Apo A levels are reduced in undialyzed uremics and remain low during hemodialysis, as well as in patients with renal allografts of less than 6 mo. duration. In renal transplant recipients of greater than 1 yr duration, apo A levels are normalized. The normalization of apo A level is related to graft function stability as determined by sequential analysis of 15 renal transplant recipients. Apo B levels are normal in uremic and dialyzed patients, but are elevated in long term transplant recipients. Unlike apo A levels, this alteration does not appear to reflect the restoration of kidney function.