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Lipoprotein (a) in chronic renal failure: effect of maintenance hemodialysis

Om Prakash Kalra1, Ambar Khaira, Jasvinder Kaur Gambhir

  • 1Division of Nephrology, Department of Medicine, Delhi, India. opkalra1@yahoo.com

Hemodialysis International. International Symposium on Home Hemodialysis
|April 22, 2009
PubMed

Insights

Lipoprotein (a) levels are elevated in chronic kidney disease (CKD) and decrease with maintenance hemodialysis (MHD). This suggests MHD may reduce cardiovascular risk in CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Chemistry

Background:

  • Coronary artery disease (CAD) poses significant risks for chronic kidney disease (CKD) patients.
  • Uremia-related factors, including elevated lipoprotein (a) (Lp(a)), contribute to accelerated atherosclerosis in CKD.
  • The impact of maintenance hemodialysis (MHD) on Lp(a) levels remains unclear.

Purpose of the Study:

  • To investigate Lp(a) levels in Stage 4 and Stage 5 CKD patients.
  • To determine the effect of MHD on Lp(a) levels in Stage 5 CKD patients.

Main Methods:

  • Plasma Lp(a) was measured using ELISA in 15 Stage 4 CKD patients, 15 Stage 5 CKD patients, and 15 healthy controls.
  • Lp(a) levels were re-assessed after 4 weeks of MHD in Stage 5 CKD patients undergoing 4-hour sessions, 2-3 times weekly.

Main Results:

  • Mean Lp(a) levels were significantly higher in CKD patients (Stage 4: 34.0 ± 19.5 mg/dL; Stage 5: 49.0 ± 30.9 mg/dL) compared to controls (22.2 ± 16.4 mg/dL).
  • Four weeks of MHD resulted in a significant 23.6% reduction in Lp(a) levels in Stage 5 CKD patients (P < 0.001).

Conclusions:

  • Elevated Lp(a) levels are present early in CKD and increase with disease severity.
  • Initiation of MHD effectively lowers Lp(a) levels.
  • Reducing Lp(a) through MHD may offer long-term benefits in mitigating cardiovascular morbidity and mortality in CKD patients.
Abstract

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