Modulation of renal injury by lipids: Experimental and clinical data

Studies in a variety of experimental models of renal disease have indicated that a number of factors participate in the progression of renal disease. Systemic and glomerular hypertension have been shown to be important factors in renal injury. Hyperlipidemia that frequently accompanies various renal diseases also has been suggested as an important participatory factor in nephron damage. Recently, factors that govern hypertrophic/hyperplastic growth also have been postulated to be involved in glomerular and tubulointerstitial injury. Recent studies have demonstrated that both hypertension and hyperlipidemia, directly or indirectly, may interact at the level of the glomerulus in a variety of ways. Not only does hypertension exaggerate hyperlipidemic glomerular injury, but hyperlipidemia alters systemic and glomerular production of vasoactive factors. Considering the complexities of these interactions, it is not possible that different interventional strategies aimed at these risk factors will be required to maximize the preservation of renal parenchyma and function in patients with progressive renal insufficiency.