SERUM PARAOXONASE-1 AS AN INDICATOR OF OXIDATIVE LIPID INJURY AND PHARMACOTHERAPEUTIC RESPONSE IN STAGE 3A CHRONIC KIDNEY DISEASE

Abstract

Background: Chronic kidney disease (CKD) raises the risk of cardiovascular problems, mainly because of dyslipidaemia and oxidative stress. In stage 3 CKD, early metabolic changes can affect lipoprotein function, even before renal function declines further. Paraoxonase-1 (PON1) is an antioxidant enzyme linked to HDL that helps prevent lipid peroxidation and stops LDL from being oxidised. Reduced PON1 activity leads to increased oxidised LDL, raising the risk of early atherosclerosis. In Stage 3a chronic kidney disease, early pharmacological intervention is crucial to slow progression and reduce cardiovascular risk. Objective: To evaluate serum Paraoxonase-1 (PON1) as an indicator of oxidative lipid injury and to assess its association with pharmacotherapeutic response in Stage 3a CKD patients with and without dyslipidaemia. Methods: A hospital-based case–control study was conducted among 135 subjects aged 30–60 years, including healthy controls (n = 45), Stage 3a CKD patients without dyslipidaemia (n = 45), and those with dyslipidaemia (n = 45). Serum PON1 was measured using ELISA, while lipid profile and renal parameters were analyzed using an automated biochemistry analyzer. Drug history, including statins, was recorded. Statistical analysis was performed using SPSS version 15.0, including one-way ANOVA, Tukey's post hoc test, and correlation analysis, with p < 0.05 considered significant. Results: Serum PON1 levels were significantly reduced, while LDL levels were elevated in Stage 3a CKD patients compared to controls (p < 0.05). Stage 3a CKD patients with dyslipidaemia showed the most pronounced changes. A significant inverse correlation was observed between PON1 and Ox-LDL levels. Statin users showed higher PON1 levels and a better lipid profile, including lower total cholesterol, LDL, triglycerides, and VLDL, and higher HDL. Pharmacotherapy also reduced oxidative stress and improved antioxidant status. Conclusion: Serum Paraoxonase-1 is a sensitive biomarker for oxidative lipid injury and atherogenic imbalance in Stage 3a CKD. Pharmacological interventions, especially statins, may enhance antioxidant status and lipid metabolism. These findings support the use of PON1 to monitor therapeutic response and cardiovascular risk in patients with Stage 3a CKD.