title: Effect of chronic kidney disease on macrophage cholesterol efflux.
abstract: OBJECTIVE
  Patients with chronic kidney disease (CKD) have a high risk to develop atherosclerosis. The capacity of high-density lipoproteins (HDL) or serum to accept cholesterol from macrophages and the capacity of macrophages to export excess cholesterol are critical for the atheroprotective role of reverse cholesterol transport. HDL cholesterol acceptor capacity was reported to be decreased in middle aged hemodialysis patients, but the role of confounding factors remains unclear.
  
  
  METHODS
  We measured the cholesterol acceptor capacity (CAC) of HDL or serum in 12 pediatric and 17 young adult patients with CKD stages 3-5, 14 young adult hemodialysis patients and 15 adult renal transplant recipients without associated diseases and matched controls using THP-1 macrophages. Moreover we studied the cholesterol export capacity (CEC) of patients' monocyte-derived macrophages (HMDMs) to control serum or HDL.
  
  
  RESULTS
  In adults with CKD stages 3-5 serum CAC was slightly increased, whereas CEC of HMDMs was unaltered in both, adult and pediatric patients. In hemodialysis patients, however, serum CAC was markedly reduced to 85±11% of control (p<0.001), presumably due to low serum apolipoprotein A-I. Interestingly, CEC of HMDMs from dialysis patients was increased. In transplant patients no alterations were found.
  
  
  CONCLUSIONS
  CKD without hemodialysis does not reduce cholesterol export from macrophages. Hemodialysis patients might benefit from therapies aiming to restore serum CAC by increasing apolipoprotein A-I. The enhanced export of cholesterol by HMDMs from dialysis patients may represent an adaptive response.
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Sabine M
authors.initials: SM
authors.lastname: Meier
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Anna
authors.initials: A
authors.lastname: Wultsch
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Marianne
authors.initials: M
authors.lastname: Hollaus
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Ammann
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pemberger
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Felix
authors.initials: F
authors.lastname: Liebscher
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lambers
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Fruhwürth
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Stojakovic
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors.forename: Hubert
authors.initials: H
authors.lastname: Scharnagl
authors.affiliation: University Clinic for Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Alice
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Springer
authors.affiliation: Department of Pediatrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Becker
authors.affiliation: Department of Pediatrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Aufricht
authors.affiliation: Department of Internal Medicine III, Division of Nephrology & Dialysis, Medical University of Vienna, Vienna, Austria.
authors.forename: Ammon
authors.initials: A
authors.lastname: Handisurya
authors.affiliation: Institute of Silviculture, University of Natural Resources and Life Sciences, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kapeller
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Röhrl
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria. Electronic address: herbert.stangl@meduniwien.ac.at.
authors.forename: Herbert
authors.initials: H
authors.lastname: Stangl
authors.affiliation: Department of Medical Chemistry and Pathobiochemistry, Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Witta
authors.initials: W
authors.lastname: Strobl
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002478:Cells, Cultured; D002648:Child; D002784:Cholesterol / Q000378:metabolism*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008264:Macrophages / Q000378:metabolism*; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000378:metabolism*
chemical_list: D002784:Cholesterol
keywords: Cholesterol efflux; Chronic kidney disease; HDL; Hemodialysis; Macrophage; Serum