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Epidemiology, pathophysiology and therapeutic implications of lipoprotein(a) in kidney disease

Florian Kronenberg1

  • 1Department of Medical Biology and Human Genetics, Innsbruck Medical University, Schöpfstr. 41, A-6020 Innsbruck, Austria. Florian.Kronenberg@uibk.ac.at

Expert Review of Cardiovascular Therapy
|September 8, 2004
PubMed

Insights

Chronic kidney disease patients face high cardiovascular disease risk. Lipoprotein(a) is a key nontraditional risk factor, with genetic apolipoprotein(a) variations strongly predicting outcomes.

Area of Science:

  • Nephrology
  • Cardiology
  • Genetics

Background:

  • Chronic kidney disease (CKD) significantly elevates cardiovascular disease (CVD) risk.
  • Traditional CVD risk factors have limited predictive value in CKD patients.
  • Lipoprotein(a) [LPA] emerges as a crucial nontraditional CVD risk factor in CKD.

Purpose of the Study:

  • To review the role of lipoprotein(a) in CKD.
  • To discuss genetic and nongenetic LPA alterations in kidney disease.
  • To evaluate LPA's utility in CVD risk prediction for CKD patients.

Main Methods:

  • Review of existing literature on lipoprotein(a) and chronic kidney disease.
  • Analysis of genetic (apolipoprotein(a) polymorphism) and nongenetic factors influencing LPA.
  • Assessment of LPA's predictive power for cardiovascular events and mortality in CKD.

Main Results:

  • Lipoprotein(a) levels and composition are altered in CKD.
  • Genetically determined apolipoprotein(a) polymorphism is a potent predictor of CVD and mortality in CKD.
  • LPA's role in risk stratification for CKD patients is significant.

Conclusions:

  • Lipoprotein(a) is a critical factor in understanding CVD risk in CKD.
  • Apolipoprotein(a) genetic variations offer powerful risk prediction in this population.
  • Current interventional strategies targeting LPA reduction in CKD are limited.

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