The predictive value of the antioxidative function of HDL for cardiovascular disease and graft failure in renal transplant recipients

Atherosclerosis. 2016 Jun:249:181-5. doi: 10.1016/j.atherosclerosis.2016.04.008. Epub 2016 Apr 8.


Background: Protection of low-density lipoproteins (LDL) against oxidative modification is a key anti-atherosclerotic property of high-density lipoproteins (HDL). This study evaluated the predictive value of the HDL antioxidative function for cardiovascular mortality, all-cause mortality and chronic graft failure in renal transplant recipients (RTR).

Methods: The capacity of HDL to inhibit native LDL oxidation was determined in vitro in a prospective cohort of renal transplant recipients (RTR, n = 495, median follow-up 7.0 years).

Results: The HDL antioxidative functionality was significantly higher in patients experiencing graft failure (57.4 ± 9.7%) than in those without (54.2 ± 11.3%; P = 0.039), while there were no differences for cardiovascular and all-cause mortality. Specifically glomerular filtration rate (P = 0.001) and C-reactive protein levels (P = 0.006) associated independently with antioxidative functionality in multivariate linear regression analyses. Cox regression analysis demonstrated a significant relationship between antioxidative functionality of HDL and graft failure in age-adjusted analyses, but significance was lost following adjustment for baseline kidney function and inflammatory load. No significant association was found between HDL antioxidative functionality and cardiovascular and all-cause mortality.

Conclusion: This study demonstrates that the antioxidative function of HDL (i) does not predict cardiovascular or all-cause mortality in RTR, but (ii) conceivably contributes to the development of graft failure, however, not independent of baseline kidney function and inflammatory load.

Keywords: Atherosclerosis; HDL; HDL function; Kidney transplantation; Prospective study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antioxidants / metabolism*
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / metabolism*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Survival
  • Humans
  • Inflammation
  • Kidney / physiopathology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Lipoproteins, HDL / metabolism*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prospective Studies
  • Surveys and Questionnaires
  • Transplant Recipients


  • Antioxidants
  • Lipoproteins, HDL