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Lipid Profile Is Negatively Associated with Uremic Toxins in Patients with Kidney Failure: A Tri-National Cohort

Patients with kidney failure (KF) have a high incidence of cardiovascular (CV) disease,
partly driven by insufficient clearance of uremic toxins. Recent investigations have questioned the
accepted effects of adverse lipid profile and CV risk in uremic patients. Therefore, we related a
panel of uremic toxins previously associated with CV morbidity/mortality to a full lipid profile in
a large, tri-national, cross-sectional cohort. Total, high-density lipoprotein (HDL), non-HDL, lowdensity
lipoprotein (LDL), and remnant cholesterol, as well as triglyceride, levels were associated
with five uremic toxins in a cohort of 611 adult KF patients with adjustment for clinically relevant
covariates and other patient-level variables. Univariate analyses revealed negative correlations
of total, non-HDL, and LDL cholesterol with all investigated uremic toxins. Multivariate linear
regression analyses confirmed independent, negative associations of phenylacetylglutamine with
total, non-HDL, and LDL cholesterol, while indole-3 acetic acid associated with non-HDL and LDL
cholesterol. Furthermore, trimethylamine-N-Oxide was independently and negatively associated
with non-HDL cholesterol. Sensitivity analyses largely confirmed findings in the entire cohort. In
conclusion, significant inverse associations between lipid profile and distinct uremic toxins in KF
highlight the complexity of the uremic milieu, suggesting that not all uremic toxin interactions with
conventional CV risk markers may be pathogenic.

Identiferoai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:87519
Date20 October 2023
CreatorsHobson, Sam, de Loor, Henriette, Kublickiene, Karolina, Beige, Joachim, Evenepoel, Pieter, Stenvinkel, Peter, Ebert, Thomas
PublisherMDPI
Source SetsHochschulschriftenserver (HSSS) der SLUB Dresden
LanguageEnglish
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text
Rightsinfo:eu-repo/semantics/openAccess
Relation412

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