Increased lipoprotein(a) concentrations in chronic renal failure

Area of Science:

• Nephrology
• Cardiology
• Clinical Chemistry

Background:

• Chronic renal failure (CRF) significantly elevates coronary heart disease (CHD) and dyslipidemia risk.
• Lipoprotein (a) [Lp(a)] is a recognized CHD risk factor, but its association with CRF is understudied.
• Diabetes mellitus complicates the Lp(a)-CRF relationship due to independent associations with both conditions.

Purpose of the Study:

• To investigate the association between chronic renal failure and lipoprotein (a) concentrations.
• To determine if diabetes or ethnicity confound the relationship between Lp(a) and CRF.
• To explore the impact of CRF treatment modalities and creatinine levels on Lp(a) concentrations.

Main Methods:

• Cross-sectional study comparing Lp(a) levels in 111 CRF subjects and 359 controls.
• Analysis included ethnic groups (Mexican Americans, non-Hispanic whites) and adjustment for diabetes.
• Investigated the effect of CRF treatments (diet, hemodialysis, peritoneal dialysis) and serum creatinine.

Main Results:

• Lp(a) concentrations were significantly elevated in CRF subjects across all ethnicities compared to controls.
• These elevations persisted after adjusting for diabetes and ethnicity (P < 0.001).
• CRF treatment type and serum creatinine levels did not correlate with Lp(a) concentrations.

Conclusions:

• Elevated Lp(a) levels are a characteristic finding in chronic renal failure, independent of diabetes and ethnicity.
• The early occurrence or potential causative role of high Lp(a) in CRF progression warrants further investigation.
• Increased Lp(a) in CRF patients likely contributes to their heightened risk of coronary heart disease.