Review
| Rev Diabet Stud,
2013,
10(2-3):110-120 |
DOI 10.1900/RDS.2013.10.110 |
Dyslipoproteinemia and Impairment of Renal Function in Diabetic Kidney Disease: An Analysis of Animal Studies, Observational Studies, and Clinical Trials
Chi-Chih Hung1,2, Jer-Chia Tsai1,2,3, Hung-Tien Kuo1,3, Jer-Ming Chang1,3,4, Shang-Jyh Hwang1,3, Hung-Chun Chen1,3
1Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
2These authors contributed equally to this article
3Department of Internal Medicine, Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Taiwan
4Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan
Address correspondence to: Hung-Chun Chen, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou First Road, Kaohsiung 807, Taiwan, e-mail: chenhc@kmu.edu.tw
Manuscript submitted April 10, 2013; resubmitted May 1, 2013; accepted May 14, 2013.
Keywords: albuminuria, diabetic kidney disease, dyslipoproteinemia, lipoprotein, lipid, renal disease, type 2 diabetes, triglyceride
Abstract
Dyslipoproteinemia is highly prevalent in diabetes, chronic kidney disease, and diabetic kidney disease (DKD). Both diabetes and chronic kidney disease (CKD) are associated with hypertriglyceridemia, lower high-density lipoprotein, and higher small, dense low-density lipoprotein. A number of observational studies have reported that dyslipidemia may be associated with albuminuria, renal function impairment, and end-stage renal disease (ESRD) in the general population, and especially in CKD and DKD patients. Diabetic glomerulopathy and the related albuminuria are the main manifestations of DKD. Numerous animal studies support the finding that glomerular atherosclerosis is the main mechanism of glomerulosclerosis in CKD and DKD. Some randomized, controlled trials suggest the use of statins for the prevention of albuminuria and renal function impairment in CKD and DKD patients. However, a large clinical study, the Study of Heart and Renal Protection (SHARP), does not support that statins could reduce ESRD in CKD. In this article, we analyze the complex association of dyslipoproteinemia with DKD and deduce its relevance from animal studies, observational studies, and clinical trials. We show that special subgroups could benefit from the statin treatment.
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