Kidney

Eicosapentaenoic acid

Biology

Kidney disease

Hyperlipidemia

Cholesterol

Endocrinology

Receptor

Docosahexaenoic acid

Fatty acid

Biochemistry

Polyunsaturated fatty acid

CD36

Lipid peroxidation

Lipoprotein

Insulin resistance

Oxidative stress

Inflammation

Internal medicine

Lipotoxicity

Lipid metabolism

Medicine

Chemistry

Obesity

Adipose tissue

Scavenger receptor

Diabetes mellitus

Nutrients

Obesity and hyperlipidemia are the most prevalent independent risk factors of chronic kidney disease (CKD), suggesting that lipid accumulation in the renal parenchyma is detrimental to renal function. Non-esterified fatty acids (also known as free fatty acids, FFA) are especially harmful to the kidneys. A concerted, increased FFA uptake due to high fat diets, overexpression of fatty acid uptake systems such as the CD36 scavenger receptor and the fatty acid transport proteins, and a reduced β-oxidation rate underlie the intracellular lipid accumulation in non-adipose tissues. FFAs in excess can damage podocytes, proximal tubular epithelial cells and the tubulointerstitial tissue through various mechanisms, in particular by boosting the production of reactive oxygen species (ROS) and lipid peroxidation, promoting mitochondrial damage and tissue inflammation, which result in glomerular and tubular lesions. Not all lipids are bad for the kidneys: polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) seem to help lag the progression of chronic kidney disease (CKD). Lifestyle interventions, especially dietary adjustments, and lipid-lowering drugs can contribute to improve the clinical outcome of patients with CKD.

Lipid Accumulation and Chronic Kidney Disease