scholarly journals Correlation of total cholesterol and protein in urine in patients with the NEPHROTIC syndrome

1980 ◽  
Vol 58 (21) ◽  
pp. 1215-1216 ◽  
Author(s):  
D. J�ngst ◽  
J. Wallner ◽  
H. J. Karl
Keyword(s):  
Nephrotic Syndrome ◽  
Total Cholesterol

Acquired lecithin-cholesterol acyltransferase deficiency in nephrotic syndrome

2001 ◽  
Vol 280 (5) ◽  
pp. F823-F828 ◽  
Author(s):  
N. D. Vaziri ◽  
K. Liang ◽  
J. S. Parks
Keyword(s):  
Nephrotic Syndrome ◽  
Total Cholesterol ◽  
Serum Cholesterol ◽  
Free Cholesterol ◽  
Mrna Abundance ◽  
Lcat Activity ◽  
Cholesterol Ratio ◽  
Gapdh Mrna ◽  
Plasma Lcat ◽  
Lcat Deficiency

Lecithin-cholesterol acetyltransferase (LCAT) is involved in the synthesis of plasma cholesteryl esters and is pivotal in the maturation of plasma high-density lipoprotein (HDL) and conversion of HDL3 to HDL2. In nephrotic syndrome (NS), the ratio of HDL2 to HDL3 is low even though the total concentration of HDL is generally normal. We hypothesize that the reduced HDL2/HDL3 ratio in NS is due to urinary losses of LCAT, leading to plasma LCAT deficiency. To test this hypothesis, Sprague-Dawley rats were randomized to NS (given 130 mg puromycin aminonucleoside on day 1 and 60 mg ip on day 14) or control groups and were studied on day 30. To dissect the effect of proteinuria from hypoalbuminemia, a group of Nagase rats with inherited hypoalbuminemia was included. Hepatic LCAT and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA abundance and plasma and urine LCAT activity were measured. The NS group showed a fourfold rise in serum cholesterol and triglycerides, a fivefold rise in free cholesterol, and a fourfold fall in the HDL-to-total cholesterol ratio. Despite severe hypoalbuminemia, the Nagase rats showed only a mild elevation of serum cholesterol and triglycerides with a normal serum free cholesterol and HDL-to-total cholesterol ratio. The NS group exhibited a normal hepatic LCAT-to-GAPDH mRNA ratio, a marked reduction in plasma LCAT activity, and a significant increase in urinary LCAT excretion. LCAT/GAPDH mRNA and plasma and urine LCAT were normal in Nagase rats. Thus NS led to heavy urinary losses and reduced plasma concentration of LCAT, despite normal hepatic LCAT mRNA abundance. However, hypoalbuminemia, per se, without proteinuria as seen in the Nagase rats had no effect on plasma LCAT or the HDL-to-total cholesterol ratio. Therefore, proteinuria, not hypoalbuminemia, causes LCAT deficiency and a depressed HDL-to-total cholesterol ratio in NS.

scholarly journals MO310LIPID DISORDERS IN NEPHROTIC SYNDROME

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Jose Maria Peña Porta ◽  
José Antonio Ferreras Gascó ◽  
Almudena Castellano Calvo ◽  
Ana Coscojuela Otto ◽  
Paula Juarez Mayor ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Albumin ◽  
Total Cholesterol ◽  
Charlson Comorbidity Index ◽  
Ldl Cholesterol ◽  
Atherogenic Index ◽  
Glomerular Diseases ◽  
Cholesterol Levels ◽  
Comorbidity Index ◽  
The Mean

Abstract Background and Aims Lipid disorders are a characteristic manifestation that accompanies the presentation of nephrotic syndrome (NS). The pathophysiology underlying its origin is debated in the literature. It is important to collect large series of patients to accurately characterize these manifestations. The aim of this study was to carry out an analysis of the lipid alterations detected in the presentation of NS, as well as its evolution, in a large cohort of patients treated in the Nephrology Service of a tertiary referral hospital. Method 111 NS outbreaks corresponding to 71 patients seen in the last 12 years were analyzed. Results 53 patients had a single outbreak. 18 patients (25.35%) had 2 or more outbreaks. 63.1% of the outbreaks affected males. Mean age 54.76 ± 18.46 years (17-85). Charlson comorbidity index 2.62 ± 2.43 points (0-8). The mean of drugs ingested daily prior to NS was 4 ± 3.88 (0-13) There were no significant differences between men and women regarding these three parameters. A renal biopsy was performed in the first outbreak in 67 patients with the result of: 21 membranous nephropathy, 11 minimal change nephropathy, 17 mesangial glomerulonephritis, 8 focal segmental glomerulosclerosis, 2 IgA nephropathy, 5 AA amyloidosis, 3 AL amyloidosis. 90.1% of the patients had high cholesterol levels (> 200 mg/dL). 73% of the patients had high LDL cholesterol (> 160 mg/dL). 72.1% of the patients had triglycerides (TG) above normal levels (> 150 mg/dL). 47.75% of the patients had a high atherogenic index (> 5). The mean levels at the presentation of NS were: total cholesterol 338.07 ± 111.61 mg/dL; HDL cholesterol 67.92 ± 25.46 mg/dL; LDL cholesterol 227.76 ± 99.28 mg/dL; TG 215.48 ± 97.27; atherogenic index 5.12 ± 2.47. There were no significant differences regarding these variables and the various glomerular diseases. Patients with prior dyslipidemia history, showed significantly lower cholesterol levels, 309.69 ± 98.08 mg/dL vs 363.53 ± 115.55 mg/dL, perhaps because they were already taking statins (we do not have this data). There is a significant correlation between total cholesterol and LDL cholesterol with serum albumin, but not between total cholesterol or LDL with proteinuria. There is a correlation between TG with both albumin and proteinuria. There is a significant inverse correlation between the neutrophil/lymphocyte ratio (NLR) and total cholesterol and LDL cholesterol. The higher the NLR, the lower the cholesterol. It gives the impression that the sicker/inflamed the patient is, the lower the ability to synthesize cholesterol. In our series, patients with acute kidney injury (AKI) or previous chronic kidney disease (CKD) had significantly lower cholesterol levels. AKI 306.84 ± 105.24 mg/dL vs no AKI 354.04 ± 110.50 mg/dL. CKD 293 ± 124.15 mg/dL vs no CKD 347.07 ± 106.27 mg/dL. In multivariate analysis, the variables associated with the level of total cholesterol and LDL cholesterol were serum albumin and the Charlson comorbidity index. Regarding the triglyceride level, the associated variables were serum albumin and proteinuria. In the evolution of the patients, both total cholesterol and triglycerides improved significantly after reaching NS remission: final cholesterol 190 mg/dL; Final triglycerides 141 mg/dL. Conclusion As in other series, we detected a high prevalence of lipid alterations in our population of adult patients with NS. Hypoalbuminemia appears as the factor that is independently associated with cholesterol and triglyceride levels. The lipid alterations improve in a parallel way as the NS picture does.

scholarly journals Inflammatory cytokines and lipid profile in children and adolescents with nephrotic syndrome receiving L. Plantarum: a randomized, controlled feasibility trial

2020 ◽  
Vol 66 (11) ◽  
pp. 1487-1492
Author(s):  
Patrícia Marques Fortes ◽  
Ricardo Vieira Teles Filho ◽  
Lucas Henrique Souza de Azevêdo ◽  
Victória Coelho Jácome Queiroz ◽  
Paulo Sérgio Sucasas da Costa
Keyword(s):  
Nephrotic Syndrome ◽  
Lipid Profile ◽  
Children And Adolescents ◽  
Total Cholesterol ◽  
Serum Triglyceride ◽  
Feasibility Trial ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Probiotic Group ◽  
Tnf Α

SUMMARY This study aimed to evaluate the efficacy of the action of the Lactobacillus Plantarum probiotic as a immunomodulatory and hypolipidemic agent in dyslipidemic nephrotic children and adolescents. METHODS: This is a randomized, double-blind, placebo-controlled clinical trial in pediatric, compensated or partially compensated nephrotic syndrome and dyslipidemic subjects undergoing regular outpatient follow-up. Serum lipid and TNF-α (proinflammatory) and IL-10 (anti-inflammatory) cytokine variations were evaluated. Cytokines were analyzed by enzyme-linked immunosorbent assay (ELISA). RESULTS: In the probiotic group there was a tendency to reduce TNF-α levels and increase IL-10 levels when compared to controls. Regarding the lipid profile, there was a decrease in serum triglyceride (6.0 mg / dL) and total cholesterol (41.5 mg / dL) levels in the probiotic group when compared to baseline levels, while in the control group there was an increase in serum triglyceride (49.5 mg / dL) and total cholesterol (8.0 mg / dL) levels, respectively. CONCLUSION: Preliminary results suggest that L. Plantarum showed an immunomodulatory and hypolipidemic effect in nephrotic and dyslipidemic pediatric subjects.

Thrombin Generation in Nephrotic Syndrome Is Dependent on Remission Status and Hypercholestrolemia

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2422-2422
Author(s):  
Bryce Kerlin ◽  
Amanda P. Waller ◽  
Jonathan P. Troost ◽  
Samir Parikh ◽  
William E. Smoyer ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Linear Regression ◽  
Total Cholesterol ◽  
Partial Remission ◽  
Research Funding ◽  
Thrombin Generation ◽  
Sodium Citrate ◽  
Validation Cohort ◽  
Bromocresol Purple ◽  
Plasma Albumin

Nephrotic syndrome (NS) is associated with a complex acquired hypercoagulopathy and a strong predilection for venous thromboembolic (VTE) complications. Thromboembolic disease complicates an estimated 27% of adult and 3% of pediatric NS cases. Nonetheless, routine prophylactic anticoagulation for NS remains controversial due to a lack of randomized trials demonstrating safety (bleeding) and efficacy as well as a lack to validated VTE-risk markers. We and others have previously shown that NS disease severity, as determined by proteinuria and serum albumin, is correlated with VTE-risk and may thus be a useful guide to thromboprophylaxis in the future. In animal models we have shown that hypercoagulopathy, as determined by thrombin generation assay (TGA), is proportional to NS severity and others have shown that TGA has predictive value for both incident and recurrent VTE in non-NS patients. We thus sought to determine the relationship between TGA and NS severity in human disease. Standard sodium citrate plasma aliquots (N=150) were obtained from the Nephrotic Syndrome Study Network (NEPTUNE) biorepository. Patients taking anticoagulants or antiplatelet agents were excluded. Correlated phenotypic data for each sample was collected from the NEPTUNE database. The NEPTUNE protocol defined complete NS remission a priori as UP:C <0.3 and partial remission as UP:C <3.5 with concomitant reduction of UP:C by ≥50% from diagnosis. To control for potential pre-analytical confounders which may be present in banked aliquots, an incident NS validation cohort (N=23) was established from whom plasma (collected into sodium citrate supplemented with corn trypsin inhibitor) and urine were analyzed at disease presentation. TGA was performed using the Technothrombin TGA kit and RCLow activator reagent (<3 pM tissue factor and <0.6 mM phospholipid) on 2:1 plasma:buffer dilutions and endogenous thrombin potential (ETP) was calculated as the area under the thrombin activity curve. Plasma albumin levels were determined by the bromocresol purple assay. Univariate linear and backward selection multivariable logistic regression was performed using SAS v9.4. TGA was undetectable in 3 (2%) of the NEPTUNE samples and those samples were excluded from further analysis. Univariate linear regression of ETP on the remaining 147 samples revealed significant relationships with age (B -16), proteinuria (log-urinary protein:creatinine ratio (UP:C); B 490), plasma albumin (B -657), and lipid profile components (e.g. total cholesterol B 2,129). Histologic classification of NS was not associated with ETP. ETP was significantly higher during active disease (no remission) than during complete or partial remission (Figure A). Non-linear regression modeling revealed a polynomial relationship between UP:C and ETP (Figure B) with a nadir ETP at UP:C 0.28. Multivariable modeling revealed that log-Total Cholesterol, log-UP:C (polynomial), Plasma Albumin, and Age were independently predictive of ETP (P values <0.04, respectively; Table). The final multivariable model was highly correlated with ETP (R2=0.35). Similar NS-severity univariate relationships were demonstrated in the validation cohort where log-UP:C (B 853; P<0.01) and plasma albumin (B -1,761; P=0.02) were both correlated with ETP. Proteinuria, plasma albumin, and hyperlipidemia are strongly associated with hypercoagulopathy as assessed by ETP during active NS. Analyzing these NS severity markers and ETP in relation to thrombotic events in future studies may inform their utility to guide the clinical application of thromboprophylaxis for NS patients. Disclosures Kerlin: Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Research Funding; CSL Behring: Research Funding.

scholarly journals Correlation between lipid profile and C-reactive protein in children with nephrotic syndrome

2015 ◽  
Vol 55 (1) ◽  
pp. 1
Author(s):  
Kurnia Dwi Astuti ◽  
Mohammad Heru Muryawan ◽  
Omega Mellyana
Keyword(s):  
Nephrotic Syndrome ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Active Phase ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation

Background Nephrotic syndrome (NS) causes dyslipidemia in children, which can be long term or intermittent. Dyslipidemia has long been established as a risk factor for atherosclerosis. An early sign of atherosclerosis is elevated high sensitivity C-reactive protien (hsCRP). Atherosclerosis early in life, especially in childhood, warrants an assessment for NS. Study on a correlation between lipid profile and hsCRP, as a marker of atherosclerosis, in pediatric NS patients has been limited. Objective To assess for a correlation between lipid profile and hsCRP in childhood nephrotic syndrome. Methods This cross-sectional study was undertaken on 29 children with NS in Dr. Kariadi Hospital. Serum hsCRP, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were examined in the active phase. Spearman’s test was used to analyze a possible correlation between total cholesterol, LDL, HDL and hsCRP levels. Results Mean levels of total cholesterol (454 mg/dL) and LDL (288 mg/dL) in this study were high, while the HDL level (55 mg/dL) was normal, according to US Department of Health and Human Services classifications. The median hsCRP level was 0.33 mg/L and 9 (31%) subjects had high hsCRP levels of more than 1 mg/L. There was a positive correlation between LDL level and hsCRP (r=0.423; P<0.05). Conclusions There is a weak positive correlation between LDL and hsCRP levels in children with NS.

Cytokine polymorphisms and nephrotic syndrome

2002 ◽  
Vol 102 (5) ◽  
pp. 513 ◽  
Author(s):  
PETER W. MATHIESON
Keyword(s):  
Nephrotic Syndrome
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