Plasma lipoprotein alterations and morphologic changes with lipid deposition in the kidney of patients with hepatorenal syndrome
Hovig, T.; Blomhoff, J.P.; Holme, R.; Flatmark, A.; Gjone, E.
Laboratory Investigation; a Journal of Technical Methods and Pathology 38(5): 540-549
1978
ISSN/ISBN: 0023-6837 PMID: 642455 Document Number: 135383
Four patients with advanced liver disease and progressive renal failure compatible with the diagnosis of hepatorenal syndrome were studied. All 4 patients and low lecithin:cholesterol acyltransferase activity in plasma and the concentration of cholesteryl esters was markedly reduced. The main lipoprotein classes were abnormal with an increased content of polar lipids. EM of negatively stained lipoproteins from 2 of the patients revealed large particles with layered membranes (700-2000 .ANG. in diameter) corresponding to the large MW fraction of the low density lipoproteins. These structures were not present in the low density lipoproteins from the other two patients. In the renal biopsy from 1 and in the necropsy specimen from another, deposition of osmophilic material was found in the glomeruli (especially located subendothelially), in the basement membrane and in the mesangial regions. The deposits were similar to those previously described in patients with familial lecithin:cholesterol acyltransferase deficiency and probably represent cholesterol and phospholipids. The renal deposition of lipid may be related to the large MW low density lipoprotein fraction. The mechanisms involved in this lipid deposition were similar to those occurring in familial lecithin:cholesterol acyltransferase deficiency.