title: Elevated circulating PCSK-9 concentration in renal failure patients is corrected by renal replacement therapy.
abstract: BACKGROUND
  A high level of circulating PCSK9 binds to the LDL receptor, reduces its cell's surface density and leads to hypercholesterolemia. The aim of this study was to examine the circulating PCSK9 level in patients with kidney disease.
  
  
  METHODS
  Out of the patients treated in our Departments we selected: (a) 44 patients with CKD stage 3 and 4 (b) 29 patients with CKD stage 5 on maintenance hemodialysis treatment; and (c) 20 patients after successful renal transplantation. Thirty-four subjects, without CKD formed the control group. Serum biochemical parameters' concentrations were assayed by a certified laboratory. Serum PCSK9 concentration was estimated by a commercially available ELISA kit.
  
  
  RESULTS
  The mean serum concentration of PCSK9 in patients with kidney disease was higher than in the control group (238.7 ± 64.5 vs. 536.7 ± 190.4; p < 0.001). A strong negative correlation between serum PCSK9 concentration and eGFR was found (r = -0.66; p < 0.001), as well as between serum concentrations of PCSK9 and total- (r = 0.482; p < 0.05) or LDL-cholesterol (r = 0.533; p < 0.05), but exclusively in patients not receiving statins. The elevated serum concentration of PCSK9 in patients before hemodialysis session declined afterwards, reaching the values observed in patients after kidney transplantation and in the control group.
  
  
  CONCLUSIONS
  The circulating PCSK9 concentration is increased in patients with CKD; however, this is not accompanied by hypercholesterolemia. The positive correlations between PCSK9/TCh and PCSK9/LDL-Ch have been found only in patients not treated with statins. The elevated circulating PCSK9 level is corrected by maintenance hemodialysis treatment and normalized by a successful kidney transplantation.
authors.affiliation: Department of Cardiology, Wincent a Paulo Hospital in Gdynia, Gdansk, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Konarzewski
authors.forename: Marek
authors.initials: M
authors.lastname: Szolkiewicz
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Sucajtys-Szulc
authors.forename: Joanna
authors.initials: J
authors.lastname: Blaszak
authors.forename: Slawomir
authors.initials: S
authors.lastname: Lizakowski
authors.forename: Julian
authors.initials: J
authors.lastname: Swierczynski
authors.forename: Boleslaw
authors.initials: B
authors.lastname: Rutkowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases / Q000097:blood*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000628:therapy; D012697:Serine Endopeptidases / Q000097:blood*
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases; D012697:Serine Endopeptidases