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Hyperlipidemia and kidney disease:Concepts derived from histopathology
and cell biology of the glomerulus
V.S. Kamanna, D.D. Roh and M.A. Kirschenbaum
Nephrology Section, Department of Veterans Affairs Medical
Center, Long Beach, California and the Division of Nephrology and Hypertension,
Department of Medicine, University of California, Irvine, USA
Offprint requests to: Vaijinath
S. Kamanna, Ph.D., Assistant Professor of Medicine, Director, Nephrology
Research Laboratories (151), Department of Veterans Affairs Medical Center,
5901 East Seventh Street, Long Beach, CA 90822, USA
Summary. The association between
hyperlipidemia and renal disease was noted by Virchow as early as the 19th
century. Subsequently, similar histopathological lipid depositions were
confirmed in diverse human and experimental renal diseases. Although, no
studies have been established in man to suggest a causal relationship between
lipids and the pathogenesis of renal disease, compelling evidence accumulated
in experimental animals suggests a direct role of lipids in the initiation
and progression of glomerular disease. These studies showed that cholesterol-feeding
to various experimental animals induced the development of glomerular injury.
Furthermore, the treatment of hyperlipidemic animals with lipid lowering
drugs prevented the development of glomerulosclerosis.
In this article, we will review recent advances made in
understanding various aspects of lipid-mediated renal injury including biochemical
mechanisms of hyper-lipidemia, a possible direct role of hyperlipidemia
in the pathogenesis of renal disease, pathobiological accumulation of lipids
and lipoproteins, biochemical and histological similarities between systemic
atherosclerosis and glomerulosclerosis, and cellular processes involved
in the development of glomerular disease. Furthermore, we will define cellular
and molecular hypotheses that provide putative mechanisms by which hyperlipidemia
and atherogenic lipoproteins induce series of cyto-regulatory peptide-mediated
events involved in the development of glomerular disease. Histol Histopathol
13, 169-179 (1998)
Key words: Hypercholesterolemia,
Atherogenic lipoproteins, Cytokines, Growth fractors
DOI: 10.14670/HH-13.169
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