Relationship of Hyperlipidemia and Hypoproteinemia with Severity of Nephrotic Syndrome

Abstract

Back Ground: There is a large body of literature implicating hyperlipidemia as a major risk factor
in the pathogenesis of cardiovascular disease (CVD) in the general population and it is well
known that patients with chronic kidney disease (CKD) exhibit significant alterations in lipoprotein
metabolism. Present cross sectional study was designed to find out the relation of hyperlipidemia
and hypoproteinemia with severity of nephrotic syndrome.
Material and Methods: Twenty four adults with severe nephrotic syndrome (group 1) and twenty
adults patients with less severe nephrotic syndrome (group II) between 30 to 65 years of age were
included in the study. Twenty healthy subjects with age and sex matched were enrolled as control
subjects in the study. Lipid profile including total cholesterol, free cholesterol, cholesterol ester,
triacylglycerol, phospholipids, serum proteins, albumin and urinary protein (albumin) were
estimated by using standard techniques.
Results: A significant increased level of total cholesterol, free cholesterol, cholesterol ester,
triacylglycerol, phospholipids was observed in less severe nephrotic syndrome. On the other
hand a highly significant increased level of all the components of lipids was observed in severe
nephrotic syndrome. A highly significant decreased level of serum proteins and serum albumin
with proteinuria was observed in both groups of patients as compared to normal subjects.
Conclusion: In both less severe and severe nephrotic syndrome, a complex metabolic process
occurs which may cause marked changes in protein and lipid profile which further deteriorates the
condition by enhancing the rate of progressive glomerular injury, perhaps by promoting an
intraglomerular equivalent of atherosclerosis. This constitutes an additional rationale for reducing
lipid levels in nephrotic patients.