A 35-year-old man with chronic kidney disease (stage 4, GFR 28 mL/min) presents with LDL cholesterol of 145 mg/dL despite a statin. His triglycerides are elevated at 280 mg/dL, and HDL is low at 32 mg/dL. The nephrologist notes elevated serum lipoprotein(a) and urinary loss of apolipoprotein. Which lipoprotein abnormality is most likely secondary to his renal disease?
- A)Decreased apolipoprotein A-I and A-II synthesis, reducing HDL formationGABARITO
- B)Primary overproduction of lipoprotein(a) by hepatocytes due to inflammation
- C)Increased urinary clearance of LDL particles causing selective hyperlipidemia
- D)Impaired lipoprotein lipase activity independent of apoC-II levels
- E)Deficiency of LCAT secondary to loss of albumin in proteinuria
Explicação
Chronic kidney disease causes urinary losses of apolipoprotein A-I, A-II, and other small apolipoproteins. This reduces HDL formation and maturation, contributing to low HDL cholesterol. CKD also increases hepatic VLDL production via insulin resistance and imp... Ver explicação completa e trilha adaptativa →