Lipid deposition in kidneys in experimental liver disease: a study in dogs with choledochocaval anastomosis

To study the ultrastructural changes in kidneys in an experimental model with an increase in the plasma concentration of lipoproteins rich in free cholesterol and phospholipids, cholecystectomy and choledochocaval anastomosis were performed in four dogs. In three dogs the glomeruli were markedly abnormal with deposition of osmiophilic material mainly in the subendothelial regions. The isolated glomeruli contained increased amounts of free cholesterol and phospholipids. In these dogs the plasma concentrations of free cholesterol and phospholipids rose markedly and cholesteryl esters fell. Abnormal plasma lipoprotein particles ultrastructurally similar to those seen in human cholestatic liver disease and in familial deficiency of the enzyme lecithin:cholesterol acyltransferase (LCAT) were found. Large myelin structures in the low density lipoprotein (LDL) range were especially prominent. Serum creatinine and urea concentrations were normal. In the fourth dog there was complete obstruction of the bile duct at the suture line, and changes in plasma lipids and lipoproteins were less pronounced. Large myelin structures were not present in LDL. The glomerular ultrastructure and lipid content were normal. This study demonstrates that lipid is deposited in the glomeruli in dogs when plasma lipoproteins rich in free cholesterol and phospholipids are present in increased concentration. The results suggest that the large myelin structures found in the subendothelial regions of the glomeruli originate from similar particles present in plasma LDL by filtration.