Accelerated atherosclerosis, dyslipidemia, and oxidative stress in end-stage renal disease

Surekha Mathur, Sridevi Devaraj, Ishwarlal Jialal

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Premature atherosclerosis is a major cause of morbidity and mortality in end-stage renal disease patients. Dyslipidemia and increased oxidative stress contribute to premature atherogenesis in these patients. The dyslipidemia of end-stage renal disease consists of both quantitative and qualitative abnormalities in serum lipoproteins. Qualitative changes include hypertriglyceridemia (increased remnant lipoproteins), low high-density lipoprotein-cholesterol, and increased lipoprotein (a). In addition to quantitative changes, lipoproteins in end-stage renal disease undergo compositional and qualitative changes that make them pro-atherogenic, such as various modifications of apolipoprotein B, including oxidation, and modification by advanced glycation end-products. The 3-hydroxy-3- methylglutaryl coenzyme A reductase inhibitors and low-dose fibrates could be effective therapies for lipid disorders. The best evidence for increased oxidative stress in end-stage renal disease is the demonstration of increased plasma F2-isoprostanes. Confirmation of the positive findings with high-dose α-tocopherol in the Secondary Prevention with Antioxidants of Cardiovascular Disease in End-stage Renal Disease Study is urgently needed. Clinical trials with statins and other drugs that improve dyslipidemia also need to be undertaken. These therapies could clearly lead to a reduction in cardiovascular morbidity and mortality in these patients.

Original languageEnglish (US)
Pages (from-to)141-147
Number of pages7
JournalCurrent Opinion in Nephrology and Hypertension
Volume11
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Dyslipidemias
Chronic Kidney Failure
Atherosclerosis
Oxidative Stress
Lipoproteins
F2-Isoprostanes
Morbidity
Fibric Acids
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Advanced Glycosylation End Products
Lipoprotein(a)
Tocopherols
Mortality
Hypertriglyceridemia
Apolipoproteins B
Secondary Prevention
LDL Cholesterol
HDL Cholesterol
Oxidoreductases
Cardiovascular Diseases

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine

Cite this

Accelerated atherosclerosis, dyslipidemia, and oxidative stress in end-stage renal disease. / Mathur, Surekha; Devaraj, Sridevi; Jialal, Ishwarlal.

In: Current Opinion in Nephrology and Hypertension, Vol. 11, No. 2, 2002, p. 141-147.

Research output: Contribution to journalArticle

Mathur, Surekha ; Devaraj, Sridevi ; Jialal, Ishwarlal. / Accelerated atherosclerosis, dyslipidemia, and oxidative stress in end-stage renal disease. In: Current Opinion in Nephrology and Hypertension. 2002 ; Vol. 11, No. 2. pp. 141-147.
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