title: High-density lipoprotein: structural and functional changes under uremic conditions and the therapeutic consequences.
abstract: High-density lipoprotein (HDL) has attracted interest as a therapeutic target in cardiovascular diseases in recent years. Although many functional mechanisms of the vascular protective effects of HDL have been identified, increasing the HDL plasma level has not been successful in all patient cohorts with increased cardiovascular risk. The composition of the HDL particle is very complex and includes diverse lipids and proteins that can be modified in disease conditions. In patients with chronic kidney disease (CKD), the accumulation of uremic toxins, high oxidative stress, and chronic micro-inflammatory conditions contribute to changes in the HDL composition and may also account for protein/lipid modifications. These conditions are associated with a decreased protective function of HDL. Therefore, the HDL quantity and the functional quality of the particle must be considered. This review summarizes the current knowledge of dyslipidemia in CKD patients, the effects of lipid-modulating therapy, and the structural modifications of HDL that are associated with dysfunction.
authors.affiliation: Department of Nephrology, Campus Benjamin Franklin, Charité - Universitaetsmedizin Berlin, Charité Centrum 13, Hindenburgdamm 30, 12203, Berlin, Germany.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Schuchardt
authors.forename: Markus
authors.initials: M
authors.lastname: Tölle
authors.forename: Markus
authors.initials: M
authors.lastname: van der Giet
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology / Q000378:metabolism* / Q000628:therapy; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008075:Lipoproteins, HDL / Q000097:blood / Q000737:chemistry / Q000378:metabolism*; D065840:Protective Factors; D011487:Protein Conformation; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology / Q000378:metabolism* / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D013329:Structure-Activity Relationship; D014511:Uremia / Q000097:blood / Q000378:metabolism* / Q000628:therapy
chemical_list: D015415:Biomarkers; D000960:Hypolipidemic Agents; D008075:Lipoproteins, HDL