Plasma PCSK9 in Nephrotic Syndrome and in Peritoneal Dialysis: A Cross-sectional Study
Background Serum total and low-density lipoprotein (LDL) cholesterol levels are elevated in patients with nephrotic syndrome and those with kidney failure treated by peritoneal dialysis (PD), who are characterized by heavy losses of protein in urine and peritoneal dialysate, respectively. Hyperchole...
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| Veröffentlicht in: | American journal of kidney diseases 2014-04, Vol.63 (4), p.584-589 |
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| creator | Jin, Kyubok, MD Park, Bong-Soo, MD Kim, Yang-Wook, MD Vaziri, Nosratola D., MD, MACP |
| description | Background Serum total and low-density lipoprotein (LDL) cholesterol levels are elevated in patients with nephrotic syndrome and those with kidney failure treated by peritoneal dialysis (PD), who are characterized by heavy losses of protein in urine and peritoneal dialysate, respectively. Hypercholesterolemia in nephrotic syndrome is associated with and largely due to acquired LDL receptor (LDLR) deficiency. Because PCSK9 (proprotein convertase subtilisin/kexin type 9) promotes degradation of LDLR, we tested the hypothesis that elevation of LDL cholesterol levels in patients with nephrotic syndrome and PD patients may be due to increased PCSK9 levels. Study Design Cross-sectional study. Setting & Participants Patients with nephrotic syndrome or treated by PD or hemodialysis and age- and sex-matched healthy Korean individuals (n = 15 in each group). Predictor Group and serum total and LDL cholesterol levels. Outcomes Plasma PCSK9 concentration. Measurements Concentrations of fasting serum PCSK9, lipids, and albumin, and urine protein excretion. Results Mean serum total and LDL cholesterol levels in patients with nephrotic syndrome (317.9 ± 104.2 [SD] and 205.9 ± 91.1 mg/dL) and PD patients (200.0 ± 27.6 and 126.7 ± 18.5 mg/dL) were significantly ( P < 0.05) higher than in hemodialysis patients (140.9 ± 22.9 and 79.1 ± 19.5 mg/dL) and the control group (166.5 ± 26.5 and 95.9 ± 25.2 mg/dL). This was associated with significantly ( P < 0.05) higher plasma PCSK9 levels in patients with nephrotic syndrome (15.13 ± 4.99 ng/mL) and PD patients (13.30 ± 1.40 ng/mL) than in the control (9.19 ± 0.60 ng/mL) and hemodialysis (7.30 ± 0.50 ng/mL) groups. Plasma PCSK9 level was directly related to total and LDL cholesterol concentrations in the study population ( r = 0.559 [ P < 0.001] and r = 0.497 [ P < 0.001], respectively). Limitations Small number of participants may limit generalizability. Conclusions Nephrotic syndrome and PD are associated with higher plasma PCSK9 concentration, which can contribute to elevation of LDL levels by promoting LDLR deficiency. |
| doi_str_mv | 10.1053/j.ajkd.2013.10.042 |
| format | Article |
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Hypercholesterolemia in nephrotic syndrome is associated with and largely due to acquired LDL receptor (LDLR) deficiency. Because PCSK9 (proprotein convertase subtilisin/kexin type 9) promotes degradation of LDLR, we tested the hypothesis that elevation of LDL cholesterol levels in patients with nephrotic syndrome and PD patients may be due to increased PCSK9 levels. Study Design Cross-sectional study. Setting & Participants Patients with nephrotic syndrome or treated by PD or hemodialysis and age- and sex-matched healthy Korean individuals (n = 15 in each group). Predictor Group and serum total and LDL cholesterol levels. Outcomes Plasma PCSK9 concentration. Measurements Concentrations of fasting serum PCSK9, lipids, and albumin, and urine protein excretion. Results Mean serum total and LDL cholesterol levels in patients with nephrotic syndrome (317.9 ± 104.2 [SD] and 205.9 ± 91.1 mg/dL) and PD patients (200.0 ± 27.6 and 126.7 ± 18.5 mg/dL) were significantly ( P < 0.05) higher than in hemodialysis patients (140.9 ± 22.9 and 79.1 ± 19.5 mg/dL) and the control group (166.5 ± 26.5 and 95.9 ± 25.2 mg/dL). This was associated with significantly ( P < 0.05) higher plasma PCSK9 levels in patients with nephrotic syndrome (15.13 ± 4.99 ng/mL) and PD patients (13.30 ± 1.40 ng/mL) than in the control (9.19 ± 0.60 ng/mL) and hemodialysis (7.30 ± 0.50 ng/mL) groups. Plasma PCSK9 level was directly related to total and LDL cholesterol concentrations in the study population ( r = 0.559 [ P < 0.001] and r = 0.497 [ P < 0.001], respectively). Limitations Small number of participants may limit generalizability. Conclusions Nephrotic syndrome and PD are associated with higher plasma PCSK9 concentration, which can contribute to elevation of LDL levels by promoting LDLR deficiency.</description><identifier>ISSN: 0272-6386</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2013.10.042</identifier><identifier>PMID: 24315769</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Apoptosis - physiology ; atherosclerosis ; Biological and medical sciences ; cardiovascular disease ; Cholesterol - blood ; Cholesterol, LDL - blood ; Comorbidity ; Cross-Sectional Studies ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Glomerulonephritis ; Humans ; Hypercholesterolemia - blood ; Hypercholesterolemia - epidemiology ; Hypercholesterolemia - prevention & control ; hyperlipidemia ; Intensive care medicine ; low-density lipoprotein (LDL) cholesterol ; low-density lipoprotein (LDL) receptor ; Male ; Medical sciences ; Middle Aged ; Nephrology ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Nephrotic Syndrome - blood ; Nephrotic Syndrome - epidemiology ; Nephrotic Syndrome - therapy ; PCSK9 (proprotein convertase subtilisin/kexin type 9) ; Peritoneal Dialysis ; Proprotein Convertase 9 ; Proprotein Convertases - blood ; Proteinuria ; Renal Dialysis ; Serine Endopeptidases - blood ; Young Adult</subject><ispartof>American journal of kidney diseases, 2014-04, Vol.63 (4), p.584-589</ispartof><rights>National Kidney Foundation, Inc.</rights><rights>2014 National Kidney Foundation, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-f7ed1d39afd11a8356a8887bc86ad2c855ec6b033d930d017e91e6991c6eb8383</citedby><cites>FETCH-LOGICAL-c485t-f7ed1d39afd11a8356a8887bc86ad2c855ec6b033d930d017e91e6991c6eb8383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S027263861301425X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28376069$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24315769$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jin, Kyubok, MD</creatorcontrib><creatorcontrib>Park, Bong-Soo, MD</creatorcontrib><creatorcontrib>Kim, Yang-Wook, MD</creatorcontrib><creatorcontrib>Vaziri, Nosratola D., MD, MACP</creatorcontrib><title>Plasma PCSK9 in Nephrotic Syndrome and in Peritoneal Dialysis: A Cross-sectional Study</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Background Serum total and low-density lipoprotein (LDL) cholesterol levels are elevated in patients with nephrotic syndrome and those with kidney failure treated by peritoneal dialysis (PD), who are characterized by heavy losses of protein in urine and peritoneal dialysate, respectively. Hypercholesterolemia in nephrotic syndrome is associated with and largely due to acquired LDL receptor (LDLR) deficiency. Because PCSK9 (proprotein convertase subtilisin/kexin type 9) promotes degradation of LDLR, we tested the hypothesis that elevation of LDL cholesterol levels in patients with nephrotic syndrome and PD patients may be due to increased PCSK9 levels. Study Design Cross-sectional study. Setting & Participants Patients with nephrotic syndrome or treated by PD or hemodialysis and age- and sex-matched healthy Korean individuals (n = 15 in each group). Predictor Group and serum total and LDL cholesterol levels. Outcomes Plasma PCSK9 concentration. Measurements Concentrations of fasting serum PCSK9, lipids, and albumin, and urine protein excretion. Results Mean serum total and LDL cholesterol levels in patients with nephrotic syndrome (317.9 ± 104.2 [SD] and 205.9 ± 91.1 mg/dL) and PD patients (200.0 ± 27.6 and 126.7 ± 18.5 mg/dL) were significantly ( P < 0.05) higher than in hemodialysis patients (140.9 ± 22.9 and 79.1 ± 19.5 mg/dL) and the control group (166.5 ± 26.5 and 95.9 ± 25.2 mg/dL). This was associated with significantly ( P < 0.05) higher plasma PCSK9 levels in patients with nephrotic syndrome (15.13 ± 4.99 ng/mL) and PD patients (13.30 ± 1.40 ng/mL) than in the control (9.19 ± 0.60 ng/mL) and hemodialysis (7.30 ± 0.50 ng/mL) groups. Plasma PCSK9 level was directly related to total and LDL cholesterol concentrations in the study population ( r = 0.559 [ P < 0.001] and r = 0.497 [ P < 0.001], respectively). Limitations Small number of participants may limit generalizability. Conclusions Nephrotic syndrome and PD are associated with higher plasma PCSK9 concentration, which can contribute to elevation of LDL levels by promoting LDLR deficiency.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Apoptosis - physiology</subject><subject>atherosclerosis</subject><subject>Biological and medical sciences</subject><subject>cardiovascular disease</subject><subject>Cholesterol - blood</subject><subject>Cholesterol, LDL - blood</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Glomerulonephritis</subject><subject>Humans</subject><subject>Hypercholesterolemia - blood</subject><subject>Hypercholesterolemia - epidemiology</subject><subject>Hypercholesterolemia - prevention & control</subject><subject>hyperlipidemia</subject><subject>Intensive care medicine</subject><subject>low-density lipoprotein (LDL) cholesterol</subject><subject>low-density lipoprotein (LDL) receptor</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Nephrotic Syndrome - blood</subject><subject>Nephrotic Syndrome - epidemiology</subject><subject>Nephrotic Syndrome - therapy</subject><subject>PCSK9 (proprotein convertase subtilisin/kexin type 9)</subject><subject>Peritoneal Dialysis</subject><subject>Proprotein Convertase 9</subject><subject>Proprotein Convertases - blood</subject><subject>Proteinuria</subject><subject>Renal Dialysis</subject><subject>Serine Endopeptidases - blood</subject><subject>Young Adult</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUuLFDEQgIMo7rj6BzxIXwQvPeYxSSciwjI-cdGBUfEWMkk1prc7GZNuof-9aWdU8OApUPVVpeorhB4SvCaYs6fd2nQ3bk0xYSWwxht6C60Ip6wWksnbaIVpQ2vBpLhA93LuMMaKCXEXXdANI7wRaoW-7HqTB1Pttvv3qvKh-gDHbymO3lb7ObgUB6hMcEtmB8mPMYDpq5fe9HP2-Vl1VW1TzLnOYEcfQ8ntx8nN99Gd1vQZHpzfS_T59atP27f19cc377ZX17XdSD7WbQOOOKZM6wgxknFhpJTNwUphHLWSc7DigBlzimGHSQOKgFCKWAGHsiO7RE9OfY8pfp8gj3rw2ULfmwBxyppwQpgisqEFpSfULgMnaPUx-cGkWROsF5-604tPvfhcYsVnKXp07j8dBnB_Sn4LLMDjM2CyNX2bTLA-_-UkawT-xT0_cVBs_PCQdLYeggXnU1GnXfT_n-PFP-W298GXH29ghtzFKRX3ZV-dqcZ6v1x-OTxhmGwo_8p-Akg1pxg</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Jin, Kyubok, MD</creator><creator>Park, Bong-Soo, MD</creator><creator>Kim, Yang-Wook, MD</creator><creator>Vaziri, Nosratola D., MD, MACP</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140401</creationdate><title>Plasma PCSK9 in Nephrotic Syndrome and in Peritoneal Dialysis: A Cross-sectional Study</title><author>Jin, Kyubok, MD ; Park, Bong-Soo, MD ; Kim, Yang-Wook, MD ; Vaziri, Nosratola D., MD, MACP</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-f7ed1d39afd11a8356a8887bc86ad2c855ec6b033d930d017e91e6991c6eb8383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Apoptosis - physiology</topic><topic>atherosclerosis</topic><topic>Biological and medical sciences</topic><topic>cardiovascular disease</topic><topic>Cholesterol - blood</topic><topic>Cholesterol, LDL - blood</topic><topic>Comorbidity</topic><topic>Cross-Sectional Studies</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Glomerulonephritis</topic><topic>Humans</topic><topic>Hypercholesterolemia - blood</topic><topic>Hypercholesterolemia - epidemiology</topic><topic>Hypercholesterolemia - prevention & control</topic><topic>hyperlipidemia</topic><topic>Intensive care medicine</topic><topic>low-density lipoprotein (LDL) cholesterol</topic><topic>low-density lipoprotein (LDL) receptor</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Nephrotic Syndrome - blood</topic><topic>Nephrotic Syndrome - epidemiology</topic><topic>Nephrotic Syndrome - therapy</topic><topic>PCSK9 (proprotein convertase subtilisin/kexin type 9)</topic><topic>Peritoneal Dialysis</topic><topic>Proprotein Convertase 9</topic><topic>Proprotein Convertases - blood</topic><topic>Proteinuria</topic><topic>Renal Dialysis</topic><topic>Serine Endopeptidases - blood</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jin, Kyubok, MD</creatorcontrib><creatorcontrib>Park, Bong-Soo, MD</creatorcontrib><creatorcontrib>Kim, Yang-Wook, MD</creatorcontrib><creatorcontrib>Vaziri, Nosratola D., MD, MACP</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jin, Kyubok, MD</au><au>Park, Bong-Soo, MD</au><au>Kim, Yang-Wook, MD</au><au>Vaziri, Nosratola D., MD, MACP</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Plasma PCSK9 in Nephrotic Syndrome and in Peritoneal Dialysis: A Cross-sectional Study</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>63</volume><issue>4</issue><spage>584</spage><epage>589</epage><pages>584-589</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract>Background Serum total and low-density lipoprotein (LDL) cholesterol levels are elevated in patients with nephrotic syndrome and those with kidney failure treated by peritoneal dialysis (PD), who are characterized by heavy losses of protein in urine and peritoneal dialysate, respectively. Hypercholesterolemia in nephrotic syndrome is associated with and largely due to acquired LDL receptor (LDLR) deficiency. Because PCSK9 (proprotein convertase subtilisin/kexin type 9) promotes degradation of LDLR, we tested the hypothesis that elevation of LDL cholesterol levels in patients with nephrotic syndrome and PD patients may be due to increased PCSK9 levels. Study Design Cross-sectional study. Setting & Participants Patients with nephrotic syndrome or treated by PD or hemodialysis and age- and sex-matched healthy Korean individuals (n = 15 in each group). Predictor Group and serum total and LDL cholesterol levels. Outcomes Plasma PCSK9 concentration. Measurements Concentrations of fasting serum PCSK9, lipids, and albumin, and urine protein excretion. Results Mean serum total and LDL cholesterol levels in patients with nephrotic syndrome (317.9 ± 104.2 [SD] and 205.9 ± 91.1 mg/dL) and PD patients (200.0 ± 27.6 and 126.7 ± 18.5 mg/dL) were significantly ( P < 0.05) higher than in hemodialysis patients (140.9 ± 22.9 and 79.1 ± 19.5 mg/dL) and the control group (166.5 ± 26.5 and 95.9 ± 25.2 mg/dL). This was associated with significantly ( P < 0.05) higher plasma PCSK9 levels in patients with nephrotic syndrome (15.13 ± 4.99 ng/mL) and PD patients (13.30 ± 1.40 ng/mL) than in the control (9.19 ± 0.60 ng/mL) and hemodialysis (7.30 ± 0.50 ng/mL) groups. Plasma PCSK9 level was directly related to total and LDL cholesterol concentrations in the study population ( r = 0.559 [ P < 0.001] and r = 0.497 [ P < 0.001], respectively). Limitations Small number of participants may limit generalizability. Conclusions Nephrotic syndrome and PD are associated with higher plasma PCSK9 concentration, which can contribute to elevation of LDL levels by promoting LDLR deficiency.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>24315769</pmid><doi>10.1053/j.ajkd.2013.10.042</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Apoptosis - physiology atherosclerosis Biological and medical sciences cardiovascular disease Cholesterol - blood Cholesterol, LDL - blood Comorbidity Cross-Sectional Studies Emergency and intensive care: renal failure. Dialysis management Female Glomerulonephritis Humans Hypercholesterolemia - blood Hypercholesterolemia - epidemiology Hypercholesterolemia - prevention & control hyperlipidemia Intensive care medicine low-density lipoprotein (LDL) cholesterol low-density lipoprotein (LDL) receptor Male Medical sciences Middle Aged Nephrology Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Nephrotic Syndrome - blood Nephrotic Syndrome - epidemiology Nephrotic Syndrome - therapy PCSK9 (proprotein convertase subtilisin/kexin type 9) Peritoneal Dialysis Proprotein Convertase 9 Proprotein Convertases - blood Proteinuria Renal Dialysis Serine Endopeptidases - blood Young Adult |
| title | Plasma PCSK9 in Nephrotic Syndrome and in Peritoneal Dialysis: A Cross-sectional Study |
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