Susceptibility of VLDL to oxidation in patients on regular haemodialysis

Oxidation of VLDL in vitro increases macrophage uptake and promotes foam cell formation, and the dyslipidaemia of chronic renal failure is characterised by an increase in VLDL. However, little information is available with regard to the susceptibility of VLDL to oxidation in patients at increased risk of atherosclerosis. We have therefore assessed the composition and susceptibility to oxidation of VLDL from haemodialysis patients and control subjects. VLDL from haemodialysis patients contained increased lipid hydroperoxides (81.6±12.6 versus 16.1±3.4 nmol/mg protein, P<0.001) and malondialdehyde (35.9±7.3 versus 16.0±4.1 nmol/mg protein, P<0.05). Susceptibility to oxidation was increased as shown by an increased rate of propagation of the copper induced lipid peroxidation chain-reaction (11.6±1.5×10−5 versus 7.6±1.1×10−5abs. U/min, P<0.05) and a greater increase in conjugated diene formation during peroxidation (0.47±0.04 versus 0.25±0.03 abs. U, P<0.001). Increased VLDL peroxidation in dialysis patients may contribute to the increased risk of cardiovascular disease observed in this group of patients.