Serum high density lipoprotein in hemodialysis patients

Uremic patients on prolonged maintenance hemodialysis (hemodialysis patients) are at high risk for atherosclerotic cardiovascular complications. To investigate the serum lipoprotein (Lp) abnormalities in hemodialysis patients, high density Lp (HDL) concentration was determined using ultracentrifugal analysis and quantitative immunoelectrophoresis in 23 hemodialysis patients, 8 non-uremic hyperlipidemic subjects, and 12 normal subjects. Immunoreactive HDL as well as HDL-cholesterol (HDL-Ch) in hemodialysis patients was lower significantly than the level in patients with non-uremic hyperlipidemia or normolipidemic healthy persons. Taking the results of previous reports into counts, decrease in HDL and HDL-Ch seems to contribute to the development of dyslipoproteinemia (broad-midband lipoproteinemia; an accumulation of the intermediate Lp or the remnant Lps) in hemodialysis patients. The results of the present study suggest that protective function proposed by the previous workers of HDL against atherosclerosis may be operated by facilitating the elimination of the accumulated midband Lps.