Inflammation
CKD enriches Lp(a) with triacylglycerols, diacylglycerols and oxidised phospholipids, 54-patient lipidomic study (J Clin Lipidol 2026)
Original title: Lipoprotein(a) lipidome and chronic kidney disease: Enrichment in triacylglycerols and diacylglycerols
Case-control lipidomic study comparing 54 nondiabetic patients with chronic kidney disease (CKD, eGFR below 60) and 39 controls, characterising Lp(a) lipid composition. Mean age was 63 years, 48% women, 77% of European descent. Lp(a)-bound oxidised phospholipids (Lp(a)-OxPL) were higher in CKD than controls (median 2.7 vs 1.2 U/L, p=0.031), particularly for medium apo(a) size (23-27 kringle repeats, p=0.002); one OxPL subspecies was markedly more abundant in CKD (21% vs 16%, p=0.0004). Of 437 individual lipid species measured in Lp(a), 146, mainly diacylglycerols, acylcarnitines and triacylglycerols, were significantly more abundant in CKD, a pattern unchanged after adjusting for Lp(a) level. The authors conclude CKD alters Lp(a) lipidomic composition toward a proinflammatory profile independent of Lp(a) concentration.
Original abstract
Background: An elevated level of lipoprotein(a) (Lp[a]) is a genetically-determined cardiovascular risk factor. A size polymorphism in its apolipoprotein(a) (apo[a]) component, expressed as kringle (K) 4 repeat numbers, is a major contributor to variability in levels. While chronic kidney disease (CKD) increases Lp(a) levels, less is known about its effect on Lp(a) molecular properties.
Objective: To assess and compare Lp(a) lipidomic properties in patients with CKD and controls.
Methods: We assessed and compared Lp(a)-lipidomic properties in 54 nondiabetic, nondialysis patients with CKD and 39 controls. CKD was defined by an estimated glomerular filtration rate of <60 mL/min/1.73 m2.
Results: The mean age of the cohort was 63 years, 48% were women, and 77% were of European descent. Lp(a)-bound oxidized phospholipids (Lp[a]-OxPL) concentrations were higher in patients with CKD vs controls (median [IQR] 2.7 [0.5; 7.4] vs 1.2 [0.5; 3.4] U/L, P = 0.031), in particular for the medium (23-27 K repeats) apo(a) size range (P = 0.002). Among Lp(a)-OxPL subspecies, 1-palmitoyl-2-(5'-oxo-valeroyl)-sn-glycero-3-phosphocholine relative abundance was significantly higher in patients with CKD compared to controls (21% vs 16%, P = 0.0004). Of the 437 individual lipid species in Lp(a), 146 species primarily representing diacylglycerols (P = 0.009), acylcarnitines (P = 0.003), and triacylglycerols (P = 0.005) showed significantly higher abundance in patients with CKD vs controls. This pattern remained unchanged after adjusting for differences in Lp(a) levels, indicating an impact of the CKD condition on Lp(a) lipidomic properties.
Conclusion: Among individuals without diabetes, kidney impairment was characterized by higher Lp(a)-OxPL concentrations and proinflammatory Lp(a)-lipidomic properties. Mechanisms underlying these changes and relevance to cardiovascular risk warrant further investigations.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.