ApoA- and apoB-containing lipoproteins and Lp(a) concentration in non-dialyzed patients with chronic renal failure
Related Experiment Video
Updated: Sep 29, 2026
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
Elibieta Kimak1, Janusz Solski
1Department of Clinical Laboratory Diagnostics, Medical University of Lublin, Poland. antuken@biotop.umcs.lublin.pl
Insights
Patients with chronic renal failure show increased atherogenic lipoproteins and Lp(a) levels, indicating a higher cardiovascular risk. Monitoring these lipid profiles can guide therapies for dyslipidemia in non-dialyzed patients.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- End-stage renal disease (ESRD) is linked to accelerated atherosclerosis and increased cardiovascular disease (CVD) incidence.
- Dyslipidemia is a common complication in chronic renal failure (CRF).
Purpose of the Study:
- To investigate serum lipid and apolipoprotein profiles, including lipoprotein(a) [Lp(a)], in patients with varying stages of chronic renal failure (CRF).
- To assess the atherogenic pattern and potential risk factors in non-dialyzed CRF patients.
Main Methods:
- Serum lipid and apolipoprotein levels were measured in 51 non-dialyzed CRF patients (27 moderate CRF, 24 ESRD).
- Patients were stratified based on creatinine levels (CRF-M: 2-6 mg/dL; ESRD: >8.5 mg/dL) and proteinuria (<0.5 g/24 h).
- Lipoprotein(a) [Lp(a)] concentrations were determined and correlated with lipid parameters.
Main Results:
- Significantly increased triglycerides (TG), apoCIII, and apoB:CIII ratios were observed in both CRF groups.
- Decreased levels of HDL-cholesterol (HDL-C) and apoA-I were noted, alongside an increased TC/HDL-C ratio.
- Serum Lp(a) concentrations were significantly elevated in both CRF groups and correlated with total cholesterol, LDL-C, and apoB.
Conclusions:
- Reduced apoA-containing lipoproteins and increased TG-rich apoB-containing lipoproteins, along with elevated Lp(a), suggest a pronounced atherogenic profile in early renal disease.
- Increased Lp(a) may stem from disturbances in its synthesis or catabolism.
- Monitoring lipoprotein profiles can aid in developing targeted therapies for dyslipidemia in non-dialyzed CRF patients.
Background:
End-Stage renal disease is associated with accelerated atherosclerosis and a high incidence of cardiovascular disease.
Methods:
The serum levels of lipids and apolipoproteins and Lp(a) were determined in 51 patients with chronic renal failure (CRF) with various advancement, without interference of factors which might disturb Lp(a) metabolism and with proteinuria less than 0.5 g/24 h. The patients studied were divided into two groups: patients with moderate renal failure (CRF-M) and creatinine levels of 2-6mg/dL n = 27; and predialysis patients with end stage renal disease (ESRD) and creatinine levels higher than 8.5 mg/dL n=24.
Results:
In both studied groups serum concentrations of triglycerides (TG), total apoCIII, apoCIIInonB, apoB:CIII were statistically increased, (except total cholestrol (TC) and LDL-cholestrol (LDL-C), apoB, total apoE, apoEnonB, apoB:E), while the levels of HDL-cholestrol (HDL-C) and apoAl significantly decreased. Lipid and lipoprotein ratios as risk factors of atherosclerosis were similar in both groups. The TC/HDL-C ratio increased, while that of HDL-C/ apoAI and apoAI/apoCIII decreased. Serum Lp(a) concentrations were significantly increased in both studied groups. The medians and ranges of Lp(a) concentration were similar in both groups. Serum Lp(a) levels correlated with total cholesterol (r=0.295; p < 0.05), LDL-C (r = 0.312; p < 0.05) and apoB (r = 0.215; p < 0.05). In addition, no correlation was found between Lp(a) levels and albumin concentrations (r = 0.126; p = 0.421).
Conclusion:
Our results may indicate that the reduced levels of apoA-containing lipoproteins and increased TG-rich apoB-containing lipoproteins and Lp(a) indicated a clear atherogenic pattern in early renal disease. Increased Lp(a) concentration may result in nonspecific synthesis or catabolism disturbances. Measurement and monitoring of lipoprotein family profiles offers a new means for selecting appropriate therapies targeted for normalizing dyslipidemia in non-dialyzed patients.
Related Concept Videos
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:28Renal Drug Excretion: Tubular Secretion
01:29Drug Distribution: Plasma Protein Binding
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance