Is oxidized low-density lipoprotein the connection between atherosclerosis, cardiovascular risk and nephrolithiasis?
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Nephrolithiasis is considered a systemic disease. A link has been established between nephrolithiasis, cardiovascular disease (CVD), the metabolic syndrome and atherosclerosis. A significant correlation has been found between the high levels of oxidized low-density lipoprotein (oxLDL) and CVD and atherosclerosis, including coronary and femoral artery disease. To the best of our knowledge, oxLDL has not been evaluated in patients with nephrolithiasis. This study aimed to evaluate serum levels of oxLDL, anti-oxLDL antibodies (oxLDL-ab) and other markers of atherosclerosis in patients with nephrolithiasis, according to the severity of the disease. The population sample consisted of 94 patients of 30–70 years of age with no symptoms of CVD who presented with renal calculi documented by ultrasonography, abdominal X-ray or computed tomography. The patients were divided into two groups: Group 1 (≥ 3 stones) and Group 2 (1–2 stones). A comparison control group was formed with 21 healthy individuals. Enzyme-linked immunosorbent assays were used to assess oxLDL and oxLDL-ab. Lipid peroxidation indexes were also analyzed. Median serum oxLDL values were higher in Groups 1 and 2 compared to the control group (≥ 3 stones, p = 0.02; 1–2 stones, p = 0.03). Median serum anti-oxLDL antibody levels were lower in the patients in Group 1 compared to the controls (p = 0.03). There was no significant difference in the oxLDL/oxLDL-ab ratio between patients and controls. These findings suggest that this may be the link between nephrolithiasis and the greater incidence of atherosclerosis and cardiovascular disease in patients with kidney stones.
KeywordsNephrolithiasis Atherosclerosis Cardiovascular disease Oxidative stress Lipoproteins
The authors are grateful to the staff of the translational research laboratory, Instituto de Medicina Integral Prof. Fernando Figueira for their support in the analysis.
ACPF conceived the original idea for the study, provided intellectual content and reviewed the manuscript. MCM contributed to the analysis of the ELISA findings. LCT and MCMBD contributed to the development of the study protocol and were involved in the evaluation and interpretation of the results and in the preparation of the manuscript. DEC and NS provided intellectual content of critical importance to the work.
This study was funded by the Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (FACEPE; Grant no. APQ-351-4.01/11).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the 1964 Helsinki declaration. The internal review board of the Instituto de Medicina Integral Prof. Fernando Figueira approved the study protocol under reference number CAAE 21614613.0.0000.5201.
Informed consent was obtained from all the individual participants included in the study.
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