SP281
CHANGES OF APOLIPOPROTEIN CIII CONCENTRATION IN CHRONIC KIDNEY DISEASE

INTRODUCTION AND AIMS: Apolipoprotein CIII (apoCIII) plays an important role in the metabolism of lipoproteins transporting triglycerides: chylomicrons and very low-density lipoproteins (VLDL). It inhibits a lipoprotein lipase activity as well as VLDL and its remnants intake in the liver; increased concentration of apoCIII is observed in patients with hypertriglyceridemia (HTG). It is thought apoCIII metabolism abnormalities could relate to lipids disorders development in chronic kidney disease (CKD), what results in accelerated atherosclerosis development and high mortality due to cardiovascular complications in this group.The aim was the assessment of kidney function impact on apoCIII concentration in the population of conservatively treated CKD patients.

METHODS: 90 CKD patients (59%males) stage 3a-4 aged 67,6 (range from 19 to 90) were included into the study. The occurrence of traditional risk factors of cardiovascular diseases such as: age, sex, arterial hypertension, obesity and an excretory kidney function (MDRD 4p formula) was evaluated. Following biochemical parameters were measured: total cholesterol, high-density lipoproteins cholesterol (HDL-CH), low-density lipoproteins cholesterol (LDL-CH), triglycerides (TG), apolipoprotein B (apoB) and apoCIII in the serum as well as in VLDL isolated from the serum through ultracentrifugation.

RESULTS: CKD stage 3a was diagnosed in 31% population, G3b in 47%, G4 in 22%. Arterial hypertension occurred in 77% patients, obesity in 30%. eGFR value correlated negatively with apoCIII concentration in the serum (r=-0,37, p=0,0003) as well as with apoCIII in VLDL (r=-0,23, p=0,03). There wasno correlation between eGFR and apoB in VLDL, which points to the changes of VLDL protein structure and accumulation of VLDL with increased apoCIII content together with renal insufficiency progression.

CONCLUSIONS: Deterioration of kidney function is accompanied by significant increase of apoCIII in VLDL, which leads to disturbances of VLDL metabolism. The modification of apoCIII metabolism could reduce cardiovascular risk in patients with CKD and become an important therapeutic target in future.