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Apo AIV in plasma and dialysate fluid of CAPD patients: comparison with other apolipoproteins
A Kandoussi1, C Cachera, R Reade
1Laboratoire de Recherches Néphrologiques, Hôpital Calmette, Lille, France.
Insights
Continuous ambulatory peritoneal dialysis (CAPD) patients exhibit higher plasma cholesterol and specific apolipoproteins compared to hemodialysis (HD). CAPD also leads to significant losses of various apolipoproteins through the dialysate fluid.
Area of Science:
- Nephrology
- Clinical Chemistry
- Biochemistry
Background:
- Chronic renal failure (CRF) significantly alters lipid metabolism.
- Dialysis modalities, hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD), may differentially impact plasma lipid and apolipoprotein profiles.
- Understanding these alterations is crucial for managing cardiovascular risk in dialysis patients.
Purpose of the Study:
- To compare plasma lipid and apolipoprotein levels in patients undergoing HD versus CAPD.
- To quantify the loss of apolipoproteins in the dialysate fluid of CAPD patients.
- To investigate the relationship between apolipoprotein molecular mass and peritoneal clearance.
Main Methods:
- Plasma lipid and apolipoprotein concentrations were measured in 18 HD patients, 18 CAPD patients, and 18 healthy controls.
- Apolipoproteins in the dialysate fluid were quantified in five CAPD patients.
- Statistical analysis was performed to compare groups and identify correlations.
Main Results:
- CAPD patients demonstrated elevated plasma cholesterol, apolipoprotein AI (apo AI), and apolipoprotein B (apo B) compared to HD patients.
- No significant difference in plasma apolipoprotein AIV (apo AIV) was found between HD and CAPD groups.
- Significant losses of multiple apolipoproteins (AI, AII, AIV, B, CII, CIII, E) were detected in CAPD dialysate, with apo AIV exhibiting higher peritoneal clearance relative to its molecular mass.
Conclusions:
- CAPD is associated with distinct alterations in plasma lipid and apolipoprotein profiles compared to HD.
- Peritoneal dialysis leads to substantial losses of various apolipoproteins, including apo AIV, which may be lost in a lipoprotein-free form.
- These findings highlight the importance of monitoring lipid profiles and considering protein losses in CAPD patients.
Abstract:
Plasma lipids and apolipoproteins were determined in 18 patients with chronic renal failure on haemodialysis (HD), 18 patients on continuous ambulatory peritoneal dialysis (CAPD), and 18 healthy controls. Significant differences were observed between the two dialysis procedures, CAPD patients showed elevated plasma cholesterol, apo AI and apoB. No significant difference in plasma apo AIV concentration was observed between the two dialysis groups. Measurement of apolipoproteins in the dialysate fluid of five patients on CAPD showed losses of all apolipoproteins (AI, AII, AIV, B, CII, CIII and E). Although daily losses of apo AI and apo AIV were similar (255 and 221 mg/day respectively), the peritoneal clearance of apo AIV was threefold that of apo AI and 12-fold that of apo B. In view of the inverse correlation between peritoneal clearance and the molecular mass of proteins, about 13% of total plasma apo AIV was lost daily as lipoprotein-free form.